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The centers alleged that UBH wrongfully denied $5 million in behavioral health treatment claims for self-insured and fully insured employer health plans for residential and outpatient treatment from 2011 to 2017. The case involves claims for 157 employer group health plan members, including children. [126]
Optum was formed as a subsidiary of UnitedHealth Group in 2011 by merging UnitedHealth Group’s existing pharmacy and care delivery services into the single Optum brand, comprising three main businesses: OptumHealth, OptumInsight and OptumRx. [2] In 2017, Optum accounted for 44 percent of UnitedHealth Group's profits. [3]
The logo of Anthem Blue Cross Blue Shield. Elevance Health, Inc. is an American for-profit health insurance provider. Prior to June 2022, Elevance Health was named Anthem, Inc. [2]
Carelon Behavioral Health, formerly known as Beacon Health Options, is a behavioral health company based in Boston, Massachusetts. On Jun. 6, 2019, Anthem, Inc. (now Elevance Health) announced that it had entered into a definitive agreement to acquire Beacon Health Options. [1] The acquisition was completed on Mar. 2, 2020. [2]
HCA Healthcare, Inc. is an American for-profit operator of health care facilities that was founded in 1968. It is based in Nashville, Tennessee, and, as of May 2020, owned and operated 186 hospitals and approximately 2,400 sites of care, including surgery centers, freestanding emergency rooms, urgent care centers and physician clinics in 20 states and the United Kingdom. [6]
As of 2023, PBMs managed pharmacy benefits for 275 million Americans and the three largest PBMs in the US, CVS Caremark, Cigna Express Scripts, and UnitedHealth Group’s Optum Rx, make up about 80% of the market share covering about 270 million people [4] [5] with a market of almost $600 billion in 2024. [6]
Catamaran Corporation (formerly SXC Health Solutions) is the former name of a company that now operates within UnitedHealth Group's OptumRX division (since July 2015). It sells pharmacy benefit management and medical record keeping services to businesses in the United States [3] and to a broad client portfolio, including health plans and employers. [4]
Tenet Healthcare Corporation is an American for-profit multinational healthcare services company based in Dallas, Texas.Through its brands, subsidiaries, joint ventures, and partnerships, [2] including United Surgical Partners International (USPI), [3] the company operates 65 hospitals and over 450 healthcare facilities. [4]