April 2025

In case you missed them, here is a recap of and links to all of the U.S. commercial articles that were published in the Provider Newsroom in April.

Updated Advanced Primary Care Management information

(April 30, 2025) Please be aware of an important change to the Cigna Healthcare^® Medicare Advantage provider manual to include information on advanced primary care management reimbursement. Effective June 1, 2025, advanced primary care management services, as defined by CMS, will not be reimbursed. 

Effective communication is key

(April 21, 2025) How well providers communicate with their patients plays a significant role in other areas of the patient experience measured by the Centers for Medicare & Medicaid Services. According to the Agency on Healthcare Research and Quality, communication “is a critical component of high-quality, safe care and the foundation of partnerships between the patient, family, and clinicians.” It only takes one bad visit to create an overall negative experience with a provider or the office.

Specialty Medical Injectables with Reimbursement Restriction

(April 15, 2025) Our Specialty Medical Injectables with Reimbursement Restriction guidelines state that certain injectables must be dispensed and their claims must be submitted by a Cigna Healthcare^®–contracted specialty pharmacy, unless otherwise authorized by Cigna Healthcare. We recently expanded the Specialty Medical Injectables with Reimbursement Restriction list to include nine specialty medical injectables. View the effective dates.

Health Care Service Corporation acquisition of Cigna Healthcare Medicare business complete 

(April 3, 2025) On March 19, 2025, The Cigna Group^® announced the completion of the sale of its Medicare and CareAllies businesses to Health Care Service Corporation (HCSC). The divestment of these assets streamlines the company’s portfolio and enables it to drive further innovation to support customers. learn more about the deal closing  and what it may mean in the future if you offer services to patients with a Cigna Healthcare^® Medicare Advantage benefit plan.