Cost-Containment

The law forbids a plan from telling participants which providers offer discounts and which providers offer what products.

Insurance examiners found late reimbursement and cost-sharing problems in 2,240 of the 4,580 behavioral care claim files reviewed in the company’s Anthem unit.

Regulators hope improved machine-readable files will help patients do a better job of shopping for care.

Some parts of the giant package have been controversial, but not these.

The new weight-loss option will cut what the plan sponsors pay as well as what the patients pay, Cigna’s PBM Evernorth says.

Tune in for a deep dive into the chaotic world of prescription drugs (are PBMs really the bad guys?), including the current state of international drugs, the impacts of the tariffs, and his predictions on what’s next in the benefits world.