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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 313
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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 325
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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 337
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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 329
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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 329
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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 284
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KFF: Insurers set to rake in $11.8B in Medicare quality bonus payments for 2024

Fierce Healthcare

billion in Medicare Advantage quality bonus payments, according to a new analysis from KFF. Health plans are set to rake in $11.8

Medicare 325