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Blue Cross Blue Shield of Arizona (AZ Blue) on June 29 unveiled the launch of Prosano Health Solutions, Inc., a new primary care subsidiary. The insurer said it intends for Prosano to “become an integral part of improving healthcare for Arizonans.” Prosano’s first “advanced primary care center,” which offers primary care, behavioral health and lab services, as well as a pharmacy and virtual care options to AZ Blue employees, is open in Maricopa County, with three additional locations planned to open in 2024. AZ Blue will also launch a new health plan, BlueSignature Prosano PPO, to employer groups next year. The Blues payer is currently the second-largest insurer in Arizona (behind UnitedHealthcare), with 998,051 members.

Startup insurer Clover Health said it has reached an agreement to settle seven shareholder-filed lawsuits that accused the Medicare Advantage-focused insurtech of concealing material information from investors before going public. In April, the company agreed to pay $22 million to settle a similar class-action lawsuit filed by shareholders, which centered on allegations outlined in a report from the activist short-selling firm Hindenburg Research. Clover did not admit wrongdoing as part of either the April settlement or the June agreement, which will resolve the remaining shareholder-led civil cases filed against it in Delaware, New York, and Tennessee courts. Clover currently enrolls 82,661 MA members in six states.

Pittsburgh-based UPMC (the University of Pittsburgh Medical Center) has signed a nonbinding letter of intent to affiliate Washington Health System, a two-hospital system based in Washington, Pa., into the UPMC system, according to a June 20 press release. “Our primary focus is to ensure the residents of Washington and Greene Counties have local access to high-quality health care that is sustainable into the future,” Brook Ward, President and CEO of Washington Health System, said in a statement. “After careful consideration and analysis, we believe the best path forward is to affiliate with UPMC to achieve that goal.” The UPMC system currently consists of more than 35 hospitals, with a network of more than 8,000 providers. Its insurance unit, UPMC Health Plan, is the third-largest insurer in Pennsylvania, with 1,512,846 members.

UnitedHealth Group’s Optum Rx on June 23 said it will add two new Humira biosimilars, Boehringer Ingelheim’s Cyltezo and Sandoz’s Hyrimoz, to its standard formulary as of July 1. Optum Rx also includes Amgen’s Amjevita, which launched in January, on its formulary. The PBM — one of the “big three” and the first to cover any Humira biosimilar at parity — will also keep Humira in its formulary. Under the pharmacy benefit, Humira is a preferred product that requires utilization management, such as step therapy and/or prior authorization, for 93.5% of Optum Rx’s pharmacy lives.

The FDA on June 20 approved Pfizer’s Talzenna (talazoparib) for the treatment of homologous recombination repair (HRR) gene-mutated metastatic castration-resistant prostate cancer (mCRPC) in adult patients, in combination with Xtandi (a Pfizer-Astellas joint venture). The win represents a broader patient population than AstraZeneca and Merck’s Lynparza (olaparib), which just weeks ago became the first PARP inhibitor to receive FDA approval to treat mCRPC. Lynparza, in combination with Johnson & Johnson’s Zytiga, is approved to treat mCRPC patients with BRCA-mutated tumors, which accounts for about 10% of the patient population. HRR mutations, meanwhile, make up about 25% of prostate cancer cases. For the treatment of metastatic prostate cancer, Lynparza currently holds preferred status for 15% of all insured lives under the pharmacy benefit, growing to 47% with utilization management restrictions applied.

North Carolina Gov. Roy Cooper (D) on June 10 signed a bill that allows Blue Cross and Blue Shield of North Carolina to transfer its assets into a holding company. “Our goal is comprehensive health insurance with access to care in every county of our state at the most affordable cost possible, and this legislation with consumer protections in place aims to keep the company strong while continuing its commitment to its North Carolina home,” Cooper said in a statement regarding HB 346. State Insurance Commissioner Mike Causey publicly opposed the measure, arguing it would limit his regulatory authority to make sure the holding company acts in the best interest of consumers, Modern Healthcare reported. State Treasurer Dale Folwell was also in opposition and pleaded with Cooper to consider amendments to the bill that he said would protect consumers. Blue Cross NC is currently the largest insurer in North Carolina, serving 2,395,993 members, 27.8% of the overall market.

Centene Corp. last week finalized its sale of Apixio, its artificial intelligence value-based care platform, to New Mountain Capital. "We are confident this transaction will best position Apixio to expand its impact as a leading artificial intelligence platform that enables value-based care programs across the country," Centene CEO Sarah London said in a statement. The company has been working to divest its “non-core assets” since 2021. Centene’s insurance units currently enroll 21,669,643 people nationwide, with 69.2% enrolled in managed Medicaid, and 9.6% enrolled in Affordable Care Act marketplace products.

CVS Health’s Aetna Better Health of Texas donated $1.1 million across 16 Texas nonprofit organizations in an aim to support access to resources that address social determinants of health. “The donations are supporting the important work of organizations that deliver culturally tailored services and positively impact non-medical drivers of health, such as food security, housing, resilience and education,” Aetna stated in a recent press release. The insurer currently serves 158,089 managed Medicaid lives in Texas.

The FDA on June 13 approved Ipsen’s Bylvay (odevixibat) for the treatment of cholestatic pruritus due to Alagille syndrome, a rare genetic disorder that can cause liver damage, in patients 12 months of age and older. Ipsen bought the ileal bile acid transport inhibitor (IBATi) when it acquired Albireo Pharma, a biotech focused on rare diseases, for $925 million earlier this year. The once-daily therapy was first approved in 2021 for the treatment of cholestatic pruritus from progressive familial intrahepatic cholestasis, another pediatric liver disorder. It currently holds covered or better status for 75% of all insured lives under the pharmacy benefit, largely with utilization management restrictions applied.

CareSource on June 7 said it is partnering with three Kansas-based nonprofits in a bid to serve the state’s revamped Medicaid managed care program, KanCare 3.0. Kansas’ current Medicaid contracts are slated to expire at the end of 2024, and the state is seeking input from providers and other Medicaid stakeholders about the new program. KanCare is currently served by three MCOs, UnitedHealthcare, Aetna and Centene Corp.’s Sunflower Health Plan, with United leading the pack at 180,584 members. Overall, the state enrolls 500,873 people in managed care plans.