The payers in question, Humana and UnitedHealthcare, deny any wrongdoing and are not obligated to pay back any money. They contend that the conclusions of the U.S. Department of Health and Human Services’ Office of Inspector General are inaccurate, and that the metrics used to make risk-adjusted calculations for reimbursement are arbitrary.

The judge did not rule that Cigna was justified in refusing to pay, but it did agree that under provisions of the NSA, federal courts have no right to compel payments. The insurer believes the decision made in the IDR proceeding was incorrect, as it and a plastic surgery provider remain in dispute over the legitimacy of reimbursement claims.

The panel has not met in over a year, despite usually meeting three times annually. The new makeup of the group signals an increasing focus on the prevention of heart disease and certain cancers.

A dozen plaintiffs filed a complaint this week, accusing the pharmacy benefit manager of failing to reimburse them for prescriptions at a rate that covers restocking costs.

The numbers come from the Urban Institute, which anticipates the erosion will vary state-by-state, depending on the speed of regulatory oversight.

Now that the kids are in college, Rod and Linda Windley are looking to sell their not-so-little piece of heaven in Sandy Springs, Ga., for $18.25 million. 

The state says Optum, a UnitedHealth subsidiary, was contracted to manage claims for a Medicaid behavioral health program, but the system it developed for the task crashed and consistently made errors. The company denies the accusations.

Researchers tracked data from more than 480,000 U.K. Biobank participants, using cardiac MRI scans to identify signs of inflammation. 

Researchers believe the approach could eventually help reduce unnecessary gadolinium exposure for some patients while maintaining useful information for diagnosis and treatment planning.