Humana Medicare Advantage plans are rated below the industry average, receiving an average rating of 3.63 stars out of 5 from the Centers for Medicare & Medicaid Services (CMS) for 2025, weighted by enrollment. For comparison, the average weighted star rating for plans from all providers is 3.9...
Humana had worked with Cotiviti on medical records requests to verify data it reported to the Centers for Medicare and Medicaid Services (CMS). As a result, Humana had authorized Cotiviti’s use of its member data to share with a subcontractor, Visionary Medical Records (VMR). A...
Centers for Medicare and Medicaid Services for failure to protect patient information. First, Humana left a file containing 17,000 current and former Medicare enrollees' personal information unsecured in a hotel computer. Second, paper copies of 250 Humana member applications were stolen from an ...
Providers that bill Medicare Advantage or Medicare Part C (“MA”), and most particularly capitated provider groups, should carefully watch a recent lawsuit filed by Humana, Inc. and Humana Benefit Plan of Texas, Inc. (“Humana...
The Centers for Medicare and Medicaid Services (CMS)have repeatedly explained that MA and Prescription Drug Plans (PDP) should enforce the MSP rules or face potential penalties. Therefore, it is becoming more important than ever for the industry to be aware of how these plans are finding out ...
For us, as a big healthcare company, we have multiple opportunities to integrate social needs into other aspects of our business. Because we are an insurance company, and we have insurance products for Medicare and Medicaid and so on, in some cases, we can incorporate social determinants into...
The company regularly reprices services 1.5 to 49 times lower than traditional methods, a study from the Office of the New York State Comptroller determined in 2020. MultiPlan, a data analytics firm, is one of the country’s largest third-party networks. The company works wit...