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The FDA on Sept. 5 granted full approval to Travere Therapeutics, Inc.’s Filspari (sparsentan) to slow kidney function decline in adults with primary IgAN who are at risk for disease progression. The agency gave the endothelin and angiotensin II receptor antagonist accelerated approval on Feb. 17, 2023, based on the surrogate marker of proteinuria. Dosing of the tablet starts at 200 mg once daily; after 14 days, dosing increases to 400 mg once daily. Drugs.com lists the price of 30 tablet of both the 200 mg and 400 mg strengths as more than $11,257. Filspari currently holds covered or better status for 74% of all insured lives under the pharmacy benefit, largely with utilization management restrictions applied.

Cigna Healthcare is launching a new “E-Treatment” option through MDLIVE by Evernorth, making virtual care more accessible and convenient for customers who have coverage through the individual marketplace or via their employer. The service allows users to receive diagnoses and treatment plans for common, lower-risk conditions such as allergies, infections, and respiratory illnesses without direct interaction via phone or video.

Elevance Health, Inc. has agreed to acquire Indiana University Health Plans, according to a Sept. 10 press release. IU Health Plans, a subsidiary of Indiana University Health, has 19,245 Medicare Advantage members and 10,868 fully insured commercial beneficiaries. It will become a part of Anthem Blue Cross and Blue Shield in Indiana, which is Elevance’s insurance affiliate in the state. The deal is subject to customary closing conditions and is expected to close by the end of the year.

Cigna CEO David Cordani has warned of “choppiness” in the coverage of GLP-1 drugs, which are used for weight loss and diabetes management, due to their high costs. Speaking at Morgan Stanley's annual Global Healthcare Conference, Cordani highlighted the challenges of balancing expanded access with affordability.

Iowa on Sept. 4 awarded Centene’s subsidiary, Iowa Total Care, a new Medicaid managed care contract, extending its participation in the state’s Medicaid program for another six years. This contract, part of the Iowa Health Link program, ensures that Centene’s Iowa Total Care will continue to provide coordinated physical, behavioral, and long-term care services to its 224,492 members across the state.

Humana Inc. announced on Aug. 29 a value-based kidney care program with Evergreen Nephrology, which has nephrology practice partnerships in 17 states. Eligible Humana Medicare Advantage members with chronic or end-stage kidney disease will gain access to Evergreen professionals, who will collaborate with the members’ existing nephrologists. Todd DeYoung, associate vice president of Humana’s specialty and value-based partnerships, said in a press release that the program will “help improve both [members’] quality of care and quality of life.” Humana currently enrolls 1,132,350 MA and dual eligible members.

Elevance Health, Inc. will offer Affordable Care Act exchange plans in three new states next year. The insurer’s Wellpoint-branded plans will expand into Florida, Maryland and Texas — all states where it has a managed Medicaid presence. According to AIS’s Directory of Health Plans, Elevance Health has 1,074,000 members enrolled in ACA exchange plans, making it the insurer’s smallest market segment. As of 2024, the insurer offered exchange plans in 10 states, with California, Virginia and New York representing its three largest markets.

A federal judge has ruled that Tennessee wrongly removed thousands of individuals from its Medicaid program, TennCare, without proper notice or the opportunity for a fair hearing, according to an Aug. 27 report in Reuters. The initial lawsuit, brought in 2019, highlighted that the state failed to comply with federal redeterminations requirements, leading to many low-income residents losing their health care coverage while still eligible for Medicaid. The case now includes disenrollments from both before and after the COVID-19 pandemic. The ruling mandates that Tennessee must reinstate coverage for those affected and ensure compliance with federal Medicaid regulations moving forward. TennCare currently serves 484,544 beneficiaries via plans offered by BlueCross BlueShield of Tennessee, UnitedHealthcare and Elevance Health.

After a two-year stalemate, Mississippi has awarded managed care contracts for its Medicaid program, according to an Aug. 28 report in Mississippi Today, resolving a prolonged period of legal battles and political disputes. The contracts, valued at $3.8 billion each, were awarded to three companies: Centene Corp.’s Magnolia Health, UnitedHealthcare and Molina Healthcare. All are incumbents to the program. This decision is expected to enhance healthcare services for Medicaid recipients by improving care coordination and access to medical services. Managed care plans will link each enrollee with a regular source of primary care, provide access to a contracted network of providers, and offer support services such as care coordination and health education. The new contracts are expected to go live in May 2025. About 70% of Mississippi’s 696,356 Medicaid beneficiaries are currently enrolled in managed care.

L.A. Care Health Plan and Centene Corp.’s Health Net announced on Aug. 28 they have launched two programs that will collectively invest $90 million over five years to help people experiencing homelessness receive access to care. The health plans will invest $60 million in the L.A. County Field Medicine Program, in which 19 providers will provide coordinated care. They also will invest $30 million in the Skid Row Care Collaborative, which will include harm reduction services, extended hours for urgent care and pharmacies, and onsite specialty medical services in Los Angeles’s Skid Row neighborhood. The programs could assist about 85,000 Los Angeles residents, according to L.A. Care and Health Net. L.A. Care is the largest Medicaid insurer in California, serving 2,365,296 members, followed by Centene at 1,704,257 members.