Thursday, January 16, 2014

Minnesota wants CMS to investigate Humana’s Medicare Advantage plans

Minnesota Attorney General Lori Swanson is asking the CMS to investigate Medicare Advantage plans offered by Humana and has presented regulators with more than 25 affidavits of complaints from beneficiaries.

The affidavits allege, for instance, that Humana denied reimbursement for services that it is required to cover for all Medicare beneficiaries—including diagnostic ultrasounds, mammograms and care in a skilled-nursing facility for a stroke patient.

The letter also said, among other complaints, that the Louisville, Ky.-based insurer created confusion by not adequately disclosing which providers were in-network and does not comply with required appeals processes.

The complaints come at a time when the popularity of Medicare Advantage plans has been escalating. And Minnesota has the highest percentage of Medicare beneficiaries enrolled in an MA plan, at 49%—compared with 28.8% of beneficiaries nationwide, the letter said. Humana has 17% of the Medicare Advantage market in Minnesota, according to Swanson’s office.

Swanson wrote that she was asking the CMS to pursue an investigation because states do not have the authority to enforce Medicare Advantage plan rules and make benefit determinations.

Full Article and Source:
Minnesota wants CMS to investigate Humana’s Medicare Advantage plans

See Also:
A Breach of Trust


Thelma said...

Any edge they can get!

Sue said...

49 more states to go. I hope this effort picks up the steam that is needed to stop the fraud on the insured, the members of the dangerous Medicare Advantage Plans and Humana is the worst of the worst 'junk'.

Daughter of a victim of Humana Medicare Advantage Plan said...

State of Minnesota Attorney General: "....Humana advertises that it provides coverage above and beyond Original Medicare, but routinely denies Medicare-covered services and supplemental plan benefits and otherwise engages in questionable claims handling and practices......"

Intentional Fraud on their members and here's the proof finally hoping more Attorney Generals join in with their complaints and I'm absolutely certain there is more if this information hit prime time news that would help.

A Breach of Trust WWII Veteran said...

Anonymous said...

Words of terror:

Humana Medicare Advantage Plan

print this out and tape it to your mirrors to remind you, don't even think of entertaining the thought of Advantage Plan ~~ go Original Medicare with a supplement. If you can't afford the supplement you'll still be better off with Original Medicare.

If you are trapped in Advantage Plan just consider the insurance company is the gatekeeper to YOUR Medicare benefits and if you think Humana will follow Medicare rules and procedures: You are dreaming.