What We're Reading: More on Cigna’s Reviews of Claims
Debbie Day, a former medical director at Cigna, alleges in an interview with ProPublica that the insurer tracked medical director productivity with a dashboard that logged how long the doctors took to review claims. Over the last few years, these metrics have taken a larger role in employee evaluations, with speed of claim review being used to determine raises and bonuses, according to Day. In this story, Cigna said the scores were not used to track the work of individual doctors.
This is a follow-up to a story last year, in which ProPublica reported that Cigna was using an algorithm to automatically deny claims. In this story, Cigna denied that the algorithm was used to reject claims without review.
Cigna has not responded to a request for comment from Formulary Watch.
Capricor Completes BLA for Deramiocel for Duchenne Cardiomyopathy
January 3rd 2025Deramiocel is a cell therapy that has healing effects in muscle cells. If approved, deramiocel would be a once-quarterly therapy and the first specifically approved for cardiomyopathy in patients with Duchenne muscular dystrophy.
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