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Humana exiting Medicare Advantage in 13 markets

Fierce Healthcare

Humana reaffirmed its full-year guidance but is leaving 13 Medicare Advantage (MA) markets next year, Chief Financial Officer Susan Diamond said during the Wells Fargo Healthcare Conference on Wedn | Humana is pulling back from Medicare Advantage markets and cutting benefits next year.

Medicare 303
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54% of Medicare eligibles enrolled in MA for 2024: KFF

Fierce Healthcare

Fifty-four percent of Medicare beneficiaries are enrolled in a private Medicare Advantage plan, and in seven states that figure tops 60%, according to a new report from KFF.

Medicare 319
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CMS: Negotiated drug prices would have saved Medicare $6B last year

Fierce Healthcare

The Centers for Medicare & Medicaid Services offered the first look at the potential savings generated by the first crop of Medicare drug price negotiations. | The Centers for Medicare & Medicaid Services offered the first look at the potential savings generated by the first crop of Medicare drug price negotiations.

Medicare 332
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Feds killed plan to curb Medicare Advantage overbilling after industry opposition

Fierce Healthcare

A decade ago, federal officials drafted a plan to discourage Medicare Advantage health insurers from overcharging the government by billions of dollars—only to abruptly back off amid an “uproar” fr | Filings and testimonies in a multibillion-dollar Justice Department civil fraud case against UnitedHealth Group outline industry pressure that led the (..)

Medicare 322
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American Medical Association slams pay cut, G-codes in proposed Medicare pay rule for doctors

Fierce Healthcare

In its comments to the Centers for Medicare and Medicaid Services (CMS) on the draft CY2025 Medicare physician fee schedule (PFS), the American Medical Association badgered CMS on its pro | The American Medical Association submitted its comment letter to CMS on its draft CY2025 Medicare physician fee schedule.

Medicare 322
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GAO: A look at cost-sharing for behavioral health in traditional Medicare, MA

Fierce Healthcare

Enrollees in both traditional Medicare and Medicare Advantage have cost-sharing obligations for behavioral health services, a GAO report shows.

Medicare 275
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Fair Square Medicare rolls out AI voice agents to help enroll seniors into insurance plans

Fierce Healthcare

Getting seniors enrolled into the right Medicare plan is typically an inefficient process that many older patients find confusing and frustrating, spending hours on the phone with human call center | Startup Fair Square Medicare is using advancements with generative AI to build AI-based voice agents to screen seniors for Medicare coverage and improve (..)

Medicare 338