UnitedHealthcare has filed a lawsuit against the director of the Idaho Department of Insurance, arguing that the state’s recent efforts to regulate Medicare Advantage plan marketing and broker commissions are in violation of the U.S. Constitution. The lawsuit, filed Nov.…
Medicare Advantage
CMS published its 2027 Medicare Advantage and Part D proposed rule on Nov. 25 that includes an overhaul of how star ratings are calculated, new enrollment flexibilities, and rollbacks of Biden-era health equity requirements. The proposed rule is subject to…
HHS is appealing a judgment that vacated CMS’ Medicare Advantage Risk Adjustment Data Validation program final rule, according to a Nov. 21 filing in the U.S. District Court for the Northern District of Texas. The 2023 final rule allowed CMS…
Blue Cross and Blue Shield of Minnesota will no longer offer gym memberships for Medicare beneficiaries at YMCA of the North and at Life Time, as of Jan. 1, both gym operators and the insurer confirmed to Becker’s. About 26,000…
Over one-half of eligible Medicare beneficiaries are enrolled in Medicare Advantage plans this year, according to KFF. Given that enrollment and recent scrutiny, all eyes are on how the private alternative to traditional Medicare gets paid. A Nov. 20 KFF…
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State insurance regulators are issuing warnings around what they describe as unfair practices by Medicare Advantage insurers to restrict enrollment. Amid rising costs and increased regulatory pressures, insurers have been adjusting their broker commission structures this year as many look…
The Idaho Department of Insurance has ordered UnitedHealthcare and PacificSource Health Plans to immediately cease and desist practices that the state says intentionally limited access to Medicare Advantage plans and cut broker commissions during the ongoing open enrollment period. The…
A pair of U.S. senators sent a letter to CMS Administrator Mehmet Oz, MD, seeking answers for what they described as a “rushed launch” of the Medicare Advantage provider-directory tool. Sens. Jeff Merkley, D-Ore., and Ron Wyden, D-Ore., said in…
Special needs plans are far from new, but they continue to hold promise as some insurers step back from Medicare Advantage. One KFF analysis attributed about half of MA enrollment growth since 2024 to SNPs, with 21% of 2025 MA…
UnitedHealth Group is projecting its Medicare Advantage enrollment will decrease by 1 million people in 2026. That estimate is up from a 600,000-member decrease it projected in July. UnitedHealthcare CEO Tim Noel said on the company’s Oct. 28 earnings call…