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Summary of Provider Newsroom U.S. commercial medical articles
Effective date
Oct 31, 2026
Identified
Nov 7, 2026
Summary
Cigna Healthcare's October 2026 Provider Newsroom recap lists several U.S. commercial items, most notably a prior authorization portal change: effective October 31, 2026, EviCore by Evernorth will move prior authorization requests for certain Cigna Healthcare services from the MedSolutions portal to the CareCore portal on EviCore.com. Other items cover drug list updates for Cigna Specialty Care Options and Cigna Pathwell Specialty, a Specialty Medical Injectables reimbursement restriction requiring dispensing and claim submission through a Cigna-contracted specialty pharmacy, and a 270/271 eligibility transaction enhancement.
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What to do
Action · 5 steps
01Already effective October 31, 2026 (confirm current status): Update the prior authorization workflow so requests for the affected Cigna Healthcare services are submitted through the CareCore portal on EviCore.com rather than MedSolutions.
02Billing team and front desk staff should update portal logins, the prior auth tracker, and any scheduling checklists.
03Also, for the Specialty Medical Injectables reimbursement restriction, confirm that claims for affected injectables are routed to a Cigna-contracted specialty pharmacy unless Cigna Healthcare authorizes otherwise, and update charge entry for those drugs accordingly.
04Review the Cigna Specialty Care Options and Cigna Pathwell Specialty drug list updates against the drugs your providers prescribe and tell providers about any changes.
05Finally, confirm that your clearinghouse and eligibility workflows reflect the Phase 3 270/271 enhancements.
Original notice
Summary of Provider Newsroom U.S. commercial medical articles
providernewsroom.com · Always check the source before changing claims.
Related changes
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