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Posts tagged with "Cigna"

Arizona News

Arizona's Devoted Health MA Network Partners with Evernorth Care Group

The health insurer covers about 13,000 Medicare lives across five counties in Arizona and earned a four-star rating in 2023 for its Medicare Advantage (MA) plans in the greater Phoenix area where Evernorth Care Group, the medical practice division of Cigna HealthCare of Arizona, operates 20 healthcare centers. Devoted Health MA...
Arizona Comings & Goings

CVS Health Finalizes Oak Street Health Acquisition

On Tuesday, CVS Health announced that it had completed its acquisition of Oak Street Health, a primary care provider which boasts 170 medical centers in 21 states. The acquisition is the latest in a long line of efforts by retailers to break into healthcare. CVS Health paid $10.6 billion in cash for the network, and intends to grow...
Most Provider Directory Entries Inaccurate National News

Most Provider Directory Entries Inaccurate

New research shows 83% of entries in provider directories from America's leading insurers were inaccurate. Most providers listed in directories from Aetna, Elevance, Cigna, Humana, and UnitedHealth had inaccuracies, but specialty information was much more likely to be accurate. Only 27.9% of physicians had consistently accurate...
Employers Increasingly Moving Retirees to Medicare Advantage National News

Employers Increasingly Moving Retirees to Medicare Advantage

Employers are increasingly moving retirement plans to Medicare Advantage health coverage, but the retirees in question are often upset with these moves. The City of New York recently attempted such a pivot, which led to a high-profile fight in the courtroom and public politics. Perhaps most surprisingly, the City and some unions...
Arizona News

Insurance Business Update

It's the time of year for insurers to file their fourth quarter (Q4) earnings reports for 2022. This week, Molina, Kaiser Permanente and Oscar Health posted financial metrics. Oscar Health beat the odds in 2022 by improving its medical loss ratio from 88.9% in 2021 to 85.3%, Modern Healthcare reports. But the healthtech company still...
National News

Payor News: Centene Medicaid Concern, CVS & Oak Street, Cigna Profits

As the COVID-19 public health emergency winds down, insurers of Medicaid managed care plans are bracing to lose membership. Centene is expecting it will lose 2.2 million Medicaid members during the redetermination process over the next year. According to Modern Healthcare, the company had 16 million Medicaid members at the end of...
Arizona News

Phoenix Children's and Cigna Reach Tentative Agreement

As discussions continue and the contract is being finalized, Phoenix Children’s remains an in-network provider for families with Cigna employer-sponsored health coverage. The original contract between the provider and payor was set to expire January 31, 2023. President and CEO Robert L. Meyer said the children's hospital is...
Arizona News

Phoenix Children's & Cigna in Contract Negotiations - 2023 Renewal in Jeopardy

Phoenix Children's commercial contract with Cigna expires Jan. 31, 2023 and there's no new agreement yet. One of the largest pediatric healthcare systems in the country, Phoenix Children's is located in central Phoenix and is already out of network for Arizona Cigna Marketplace and Medicare Advantage plan members, but Cigna's...
Arizona News

Marketplace OEP Competition Tightens With Bright Health Exit, Deceptive Marketing Continues & Updated RWJ Resources for Navigators

This year's surprising exit of Bright Health on the Marketplace leaves $4 billion in ACA revenue up for grabs for brand name giants including UnitedHealthcare, Centene, Cigna, and CVS, but it's some lesser known short-term plans and Healthcare Sharing Ministries that are also gaining consumer attention with deceptive marketing touting...
Marketplace Enrollment is Open! Arizona News

Marketplace Enrollment is Open!

Most shoppers who qualify for a subsidy won't feel the cost of rising Marketplace premiums and with eligibility expanded to include the cost of family coverage,  HealthCare.gov may see the busiest season ever as it celebrates its 10th open enrollment period (OEP) Nov. 1, 2022 through January 15, 2023. Eight insurers, but not...
Open Enrollment Starts November 1st: Arizona Marketplace Insurers, Rate Changes & Sample Premiums Arizona News

Open Enrollment Starts November 1st: Arizona Marketplace Insurers, Rate Changes & Sample Premiums

Seven insurers, but not Bright Health, are offering individual and family coverage in Arizona on HealthCare.gov including last year's newcomers Banner/Aetna and Medica Community Health Plan. We reviewed the plan data from the Arizona Department of Insurance and Financial Institutions and provide readers a Marketplace snapshot. Nearly...
News

MA Update: Seniors May Not Know About Insulin Cost Cap - Talk of New SEP, More Fraud Cases and an Issue with Medicare Advantage's First Name

Medicare Advantage enrollees who use insulin may not know the insulin cost cap limits all monthly out-of-pocket costs for insulin to $35 -- and that could influence how they select their Medicare Advantage plans during the open enrollment period. For the current open enrollment period, the insulin cost cap was not factored into the...
MA Update: MA Called to Task by NYT, 2023 Market Expansions and Contractions Arizona News

MA Update: MA Called to Task by NYT, 2023 Market Expansions and Contractions

As seniors, the Centers for Medicare and Medicaid Services (CMS) and Medicare Advantage (MA) plans gear up for a landmark Medicare Advantage Open Enrollment Period beginning October 15, Medicare Advantage on the whole is in hot water. Last week, the New York Times published an earthshaking story documenting the extent to which...
National News

AMA Joins Class Action Against Cigna - Alleges Underpaid Claims in MultiPlan Network

Cigna contracts with MultiPlan, the largest PPO network in the country. The insurer was accused of intentionally underpaying provider claims and increasing administrative fees in a lawsuit filed in a Connecticut federal court. The American Medical Association joined  the Medical Society of New Jersey and the Washington State Medical...
CMS Rules

No Surprises Act: Providers Need More Time to Comply, Insurers Using NSA in Rate Negotiations

The No Surprises Act has been a hot-button point of contention among insurers and providers as physician groups feel threatened by the leverage that insurers are given through the Act's enforcement. The Medical Group Management Association (MGMA) sent a letter to the U.S. Department of Health and Human Services (HHS) and the Centers for...
National News

Insuretech Startups Struggle but Their CEOs Don't

Health insurance technology startups have struggled to meet industry expectations, with several of the most lauded companies losing money quarter-to-quarter despite significant growth. But these insuretech startups' CEOs are receiving ample bonuses despite poor corporate performance. A few recent examples: Bright Health Group recorded...
Prior Authorization Delays and Denials Fueling Oncology Clinician Burnout as Cancer Patients Grapple With Complex Care National News

Prior Authorization Delays and Denials Fueling Oncology Clinician Burnout as Cancer Patients Grapple With Complex Care

The increasing burden of prior authorization, as well as the rise of “fail first” policies has become costly and harmful for patients – so much so that the American Medical Association (AMA) has engaged a law firm to pursue curtailing prior authorization. According to the American Journal of Managed Care (AJMA), Barbara...
National News

U.S. Justice Department Issues Lawsuit to Stop UnitedHealth Group’s Acquisition of Change Healthcare and More Finance News

The U.S. Justice Department officially announced a lawsuit to stop UnitedHealth Group’s acquisition of Change Healthcare this week, while companies ranging in size from startups like Sesame to mega-corporations such as Tenet and Cigna continue to seek new ways to utilize software and technology in healthcare – either for profit or...
2022 MA Star Ratings Are Here -- Arizona's Included National News

2022 MA Star Ratings Are Here -- Arizona's Included

The Centers for Medicare and Medicaid Services (CMS) released its star ratings for Medicare Advantage Part C and Part D star ratings last Thursday, ahead of Medicare open enrollment, which begins October 15. Medicare Advantage (MA) plans get a star rating from one to five each year based on performance metrics including patient...
2022 Arizona MA AEP Preview: Plans by County, Premiums, Deductibles and More Arizona News

2022 Arizona MA AEP Preview: Plans by County, Premiums, Deductibles and More

The Centers for Medicare & Medicaid Services (CMS) released key information for Medicare Advantage and Part D prescription drug plans in advance of the 2022 annual open enrollment period (OEP). Marketing and advertising for most MA plans starts October 1 with plan sales beginning October 15 and ending December 7, 2021. Arizona...
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