Payer Roundup—Moody's: Anthem’s accelerated PBM launch bad for Cigna

Anthem headquarters
An accelerated launch of Anthem's in-house PBM may impact Cigna's bottom line. (Anthem)

Moody’s: Anthem’s accelerated PBM launch is bad for Cigna 

Anthem’s plan to accelerate the launch of its in-house pharmacy benefit manager, IngenioRx, is credit positive—but it's not good news for Cigna, according to a new Moody’s Investors Service report. 

Moody’s said that bumping up the launch from early 2020 to spring 2019 improves the credit outlook at cash flow for this year at Anthem. However, it will reduce cash flow to Cigna—which now owns Anthem’s previous PBM, Express Scripts—by $750 million to $800 million in 2019. 

This is a credit negative situation, according to Moody’s as it lessens Cigna’s financial cushion if the Express Scripts integration doesn’t fare as well as planned or if there are losses elsewhere.  


13th Partnering with ACOS & IDNS Summit

This two-day summit taking place on June 10–11, 2019, offers a unique opportunity to have invaluable face-to-face time with key executives from various ACOs and IDNs from the entire nation – totaling over 3.5 million patients served in 2018. Exclusively at this summit, attendees are provided with inside information and data from case studies on how to structure an ACO/IDN pitch, allowing them to gain the tools to position their organization as a “strategic partner” to ACOs and IDNs, rather than a merely a “vendor.”

Judge tosses Maryland’s suit in defense of the ACA 

A Baltimore-based district court judge has thrown out Maryland officials’ lawsuit against the Trump administration, saying the state attorney general failed to prove the White House will not enforce the Affordable Care Act. 

The suit, filed by Attorney General Brian Frost, is mostly “conjecture” and guesses about what President Donald Trump and his administration may do, Judge Ellen Hollander said. 

“In effect, the state proclaims that the sky is falling,” Hollander said. “But falling acorns, even several of them, do not amount to a falling sky.” 

Frosh said in a statement that his office will continue to defend the ACA. (Reuters

Texas AG seeks permission to drop Planned Parenthood from Medicaid coverage 

Texas Attorney General Ken Paxton is seeking permission to remove Planned Parenthood from the state’s Medicaid program as the legal fight to permanently block the provider plays out.

Paxton’s office initially sought to remove Planned Parenthood from Medicaid following a series of videos that allegedly showed staff at its clinics agreeing to illegally perform abortions to obtain samples for fetal tissue research. A district court judge issued an injunction, saying the videos show no proof of wrongdoing.

However, an appeals court overturned that injunction, sending the case back down for further analysis. The court will rule on Feb. 8. 

“There is no justification for continuing to prevent Texas from terminating Planned Parenthood from the state’s Medicaid program when the 5th Circuit has already determined the district court’s injunction is unlawful,” Paxton said in a statement. (Austin American-Statesman

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