Cigna sued by shareholder over PXDX
Plus: CA approves $25/hr minimum wage for healthcare workers
Good morning and happy Friday. We have another brief edition of the Friday Pulse Check for you this morning.
In the news:
Cigna shareholder suing following ProPublica report
A Cigna shareholder is suing the health insurance giant to obtain more information about its use of PXDX, a computer system created to routinely deny medical claims. The shareholder, Charles Blackburn, says he did not receive the information he requested from Cigna following the report, which included details about the "legality or financial impact" of the PXDX tool. He is looking to "investigate possible mismanagement and/or breaches of fiduciary duty and other wrongdoing" by Cigna, and additional lawsuits could occur.
"There is reason to believe that the company's use of automated systems to deny insurance claims will result in regulatory action and has already caused reputational harm," the complaint said, per Law360. In ProPublica’s investigative piece, our own Ron Howrigon was prominently featured, and you can read that investigation here. Read more in Law360.
LIVE Cigna stock price: CI 0.00%↑
J&J under investigation in South Africa over drug prices
Pharmaceutical giant Johnson & Johnson is under investigation in South Africa over the high prices of some of its drugs. South Africa's Competition Commission, which regulates business practices, said it opened the investigation this week based on information that the companies “may have engaged in exclusionary practices and excessive pricing” of the tuberculosis drug bedaquiline, which is sold under the brand name Sirturo. Tuberculosis is one of the leading causes of death in South Africa, killing 50,000 people in 2021. Read more in US News.
LIVE Johnson & Johnson stock price: JNJ 0.00%↑
Other articles of interest:
The FLATLINING Podcast from Fulcrum Strategies
This week on the podcast, Ron and I broke down several healthcare news items that are relevant to the business administration of provider practices. We took a look at these stories:
We also discussed whether or not the prior authorization cuts will help patients and their physicians. We also talked about ACA Marketplace plan reimbursement and how the record enrollments will affect provider revenue. And we shared some tips on what to do in nasty negotiations.
Have a good weekend,