Optum Rx — which includes the PBM of healthcare conglomerate UnitedHealth Group — is dropping annual reauthorization requirements for 80 drugs, which will eliminate more than 10% of overall pharmacy prior authorizations.
A partnership between AARP, the top interest group in the United States dedicated to the plight of seniors, is facing growing scrutiny over its partnership with UnitedHealthcare as the healthcare giant faces a growing number of controversies. "AARP now makes over a billion dollars a year in corporate royalties, more than triple what they make in membership dues," American Commitment President Phil Kerpen told Fox News Digital. "The vast majority of those royalties come from the country's largest insurance company, UnitedHealthGroup, via a skim of 5% of the monthly premiums in the AARP-branded UnitedHealth insurance products. AARP's lobbying work always advances the interests of UnitedHealth rather than seniors. Seniors, for instance, overwhelmingly opposed the Inflation Reduction Act, but UnitedHealth loved its price controls and supersized Obamacare subsidies, so AARP went all out for it." AARP began a partnership with UnitedHealth in 1997 where AARP offers its nearly 38 million members UnitedHealth Medicare-related products, with AARP branding in what Forbes reported amounted to a "marketing coup."
Health policy experts warn that any cuts to Medicaid are likely to cause more trouble for rural hospitals than urban ones. That's due in part because rural residents are more likely to be enrolled in Medicaid.
Anthem Health Plans has been ordered to pay back 446 Virginians, who filed claims between 2021 and 2024, $216,964 because the insurer charged a copay to customers for a contraceptive deemed necessary by their doctor. Virginia requires insurance companies to cover preventive services without charging co-pays. Cigna Healthcare was ordered to reimburse 457 customers about $404,000; the company had told them it would lower the amounts it paid, based on the level of Medicare coverage patients had. Virginia prohibits that.
Cigna Group has appointed Brian Evanko as president and COO of the company, effective March 31. Evanko has been serving as CEO of Cigna Healthcare since January 2024, with oversight of all Cigna Healthcare businesses. Evanko also serves as CFO of Cigna Group, a role he has held since 2021. In his new position, Evanko will oversee all of the company’s business lines. He will report to chairman and CEO David Cordani.
Blue Cross Blue Shield of Oklahoma is requiring that its covered patients who have severe asthma to inject themselves with their medicine rather than asking a clinic or doctor for assistance. Patients who take injections like Xolair, Tezspire, Fasenra and Nucala, no matter their age, are at risk. Brad Traverse with Infusion Providers Alliance says the policy change "is purely a money reason."