The Cigna Group Announces Agreement to Sell Medicare Business
The Cigna Group announced an agreement to sell our Medicare Advantage, Cigna Supplemental Benefits, and Medicare Part D businesses to Health Care Service Corporation (HCSC).
With this announcement, there are no changes to your coverage, benefits, or costs. You do not need to take any action. Cigna Healthcare will continue to serve all our customers and handle claims as we have always done.
As we move forward, there are many steps for us to take. Your plans and coverage will not move to HCSC until the transaction is complete, which we expect to happen early in 2025, subject to regulatory approvals.
As we draw closer to completing the transaction, we will keep you informed of the process. Should anything change as it relates to your plan, we will provide you with as much advance notice as possible.
HCSC is the country’s largest customer-owned health insurer, serving members for nearly a century. They have committed to expanding Medicare access and providing members with quality, affordable access to care in all phases of their lives. We are confident that you will continue to receive the excellent quality service and care you have come to expect from Cigna Healthcare.
Thank you for being a valued customer. We are honored to serve you. If you have any questions or concerns, please do not hesitate to contact Cigna.
Speaking of driving up the cost of care. KFF is out with a startling report on Prior Authorization. Click here.
More than 46 million prior authorization requests were submitted to Medicare Advantage insurers on behalf of enrollees in 2022, up from 37 million in 2019.
There were 1.7 prior authorization requests per Medicare Advantage enrollee, similar to the amount in 2019.
Insurers fully or partially denied 3.4 million (7.4%) prior authorization requests. The share of all prior authorization requests that were denied increased from 5.7% in 2019, 5.6% in 2020 and 5.8% in 2021 to 7.4% in 2022.
Just one in ten (9.9%) prior authorization requests that were denied were appealed in 2022. That represents an increase since 2019, when 7.5% of denied prior authorization requests were appealed
The vast majority of appeals (83.2%) resulted in overturning the initial prior authorization denial.
Major MA plans - with United Health Group in the lead - have found another way to pad their profits. A Wall Street Journal investigation of insurer home visits found the companies pushed nurses to run screening tests and add unusual diagnoses, turning the roughly hourlong stops in patients' homes into an extra $1,818 per visit, on average, from 2019 to 2021. Those payments added up to about $15 billion during that period, according to a Journal analysis of Medicare data. Click here for the WSJ story.
What does ending the Chevron doctrine mean for health care? It's too early to know the full impact, but the lawsuits keep coming. There are actually four Supreme Court decisions that are essentially working together to diminish the power of federal regulators. All of that is detailed in a new analysis developed by Strategic Health Care's General Counsel, Diane Turpin, JD, that will give you about everything you need to know right now. Click here.
Senate Committee Advances Health LegislationGetting it in under the wire before the August congressional recess, the Senate Health Committee overwhelmingly voted to move forward three health care bills. The first bill, (S 4776), sponsored by Chairman Bernie Sanders(I-VT). and Ranking Member Bill Cassidy (R-LA), would reauthorize through 2029 the Older Americans Act, which authorizes grant programs that provides meals and social supports for older adults and aims to protect them from abuse, neglect and exploitation through the long-term care ombudsman program. The second bill (S 4762), sponsored by Sen. Ben Ray Luján (D-NM), would boost funding for federal autism programs and research. And finally, a bill (S 4755), sponsored by Sen. Markwayne Mullin (R-OK), would reauthorize the traumatic brain injury program at the Centers for Disease Control and Prevention through 2029. To view the vote and the legislation that advanced, click here.
Senators Introduce Legislation to Increase Workforce PipelineSens. Ron Wyden (D-OR) and Marsha Blackburn (R-TN) introduced legislation last week that tackles critical shortages of allied health professionals, who provide a range of diagnostic, technical, therapeutic and medical support services. The bill would create a grant program to provide funding for community health centers and rural health clinics to test innovative policies aimed at developing the pipeline of these workers, including partnerships with high schools and community colleges. The grants could be used to support new and existing programs, with priority given to those who train people from underserved and disadvantaged communities. Click here for the bill.
Quality of Medicare Advantage Plans Can Depend on Geography
Geography plays a role in determining health care options and outcomes as a new study shows that enrollees living in communities of color and with high rates of poverty had less access to top-rated Medicare Advantage plans. The study, published in JAMA Network Open, showed that plans offered to beneficiaries of people living in wealthier places that are majority white averaged higher CMS star ratings. Researchers reviewed 2023 CMS data for all MA plans along with 2020 county-level Social Vulnerability Index data from the CDC. Click here to read the study.
Comments