Payer Roundup—Cigna expands its collaboration with Omada Health; California regulator files complaint against AbbVie

Omada Health
The new terms of the collaboration between Omada Health and Cigna will make the Diabetes Prevention Program available to Cigna's national and regional employer clients in January 2019. (Omada Health)

Cigna expands collaboration with Omada Health

Cigna is expanding its personalized Diabetes Prevention Program (DPP) with Omada Health.

The Bloomfield, Connecticut-based insurance giant is already partnered with digital health provider company Omada Health to offer DPP, a suite of digital lifestyle tools aimed at helping individuals avoid the onset of diabetes and other chronic diseases.

The new terms of the collaboration will make DPP available to Cigna's national and regional employer clients in January 2019. (Release

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California regulator files complaint against AbbVie

California Insurance Commissioner Dave Jones filed an insurance-fraud complaint (PDF) today against drugmaker AbbVie Inc., alleging a series of kickbacks to providers to prescribe its drug Humira. 

According to the complaint, AbbVie conducted a "far-reaching scheme including both classic kickbacks—cash, meals, drinks, gifts, trips, and patient referrals—and more sophisticated ones—free and valuable professional goods and services to physicians to induce and reward HUMIRA prescription." Jones said AbbVie also inserted its own personnel directly into the homes of patients. 

Jones said private insurers have paid $1.2 billion in Humira-related pharmacy claims, which would make it the largest health insurance fraud case in California's history. (Release)

Senators unveil measure to address surprise medical bills

A group of senators is unveiling a draft of new legislation they say would tackle the problem of surprise medical bills, a ubiquitous problem in which patients are hit with massive unexpected charges.

The Hill reported that the bipartisan measure would, among other things, prevent healthcare providers outside a patient's insurance network from charging additional costs for emergency services to patients beyond the amount usually allowed under their insurance plan.

Who's behind it? Sen. Bill Cassidy, R-La.; Tom Carper, D-Del.; Todd Young, R-Ind.; Claire McCaskill, D-Mo.; Michael Bennet, D-Colo. and Chuck Grassley, R-Iowa. (Release) (The Hill)

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