Evernorth, the Cigna Group’s health services arm, will cap out-of-pocket costs for Zepbound and Wegovy, two GLP-1 drugs, at $200. Members can save up to $3,600 a year compared to purchasing the drugs directly or through consumer programs, according to…
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Arkansas Blue Cross & Blue Shield reported a $226.2 million net loss in 2024 and a 15% increase in claims exceeding $1 million. President and CEO Curtis Barnett told Arkansas Business in May that members under 40 are generating seven-figure…
Eight Medicare plans have been recognized for high achievement or significant improvement in medication safety and appropriate use by the Pharmacy Quality Alliance. The awards are based on CMS’ 2025 Medicare Part D Star Ratings, where only 1.3% of the…
Leon County, Florida prosecutors have opened a criminal investigation relating to a $10 million donation from Centene to the Hope Florida Foundation, a nonprofit associated with Gov. Ron DeSantis, according to a joint report from the Miami Herald and the…
CMS cannot track whether states are repaying the federal government the correct share of funds Medicaid managed care plans do not spend on beneficiary care, according to an audit HHS Office of Inspector General published May 16. Many states require…
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UnitedHealth Group is asking shareholders to support a $60 million stock option award for its new CEO. In a May 20 letter to shareholders, Christopher Zaetta, UnitedHealth’s chief legal officer, urged shareholders to approve the company’s executive compensation. Institutional Shareholder…
Centene subsidiary Superior Health Plan’s use of private investigators did not violate any laws, an investigation by Texas’s Attorney General’s Office found. In March, Texas Attorney General Ken Paxton launched an investigation into Superior Health Plan, after former CEO Mark…
A federal judge has ruled against Florida Blue, deciding the insurer is not entitled to have its Medicare Advantage star ratings reevaluated. In December, attorneys for Florida Blue filed a lawsuit in federal district court in Washington, arguing CMS did…
California’s ACA exchange, Covered California, previously was sharing sensitive data provided by website visitors to LinkedIn through website trackers, The Markup reported in April. Visitors to the state website had information sent to Linkedin about whether they were blind, pregnant,…
Healthcare operations, such as customer care contact centers and revenue cycle departments, often face significant challenges: high volumes, stressful environments, and heavy manual workloads. These teams manage complex, repetitive tasks—like explaining insurance coverage or guiding patients through financial decisions—which can…