Medicare Advantage insurers and brokers are facing a sweeping lawsuit from the Justice Department, and rising costs continue to hurt payers’ finances.
Here are eight Medicare Advantage updates to know:
- A group of Democratic lawmakers is urging Republicans to turn their attention to Medicare Advantage to cut healthcare spending.
- Clover Health reported a major boost in profitability and overall membership in its first-quarter earnings. The company’s Medicare Advantage membership stands at 103,418, up 30% year-over-year.
- The Department of Justice filed a sweeping lawsuit against Humana, Aetna and Anthem, along with Medicare Advantage brokers eHealth, GoHealth and SelectQuote, alleging a multi-year scheme involving unlawful kickbacks and discriminatory practices against disabled MA enrollees.
- Elevance Health will remove most of its Anthem Medicare Advantage plans from online broker platforms.
- The Trump administration has boosted payment rates for Medicare Advantage plans, but some insurers have said the rates are not enough to offset lower rate increases over the past few years. Here are five things to know about the Trump administration’s approach to Medicare Advantage so far.
- Medicare Advantage costs are “elevated, but manageable,” according to Elevance Health CFO Mark Kaye. Elevance sought to reassure investors after rival UnitedHealth Group reported first-quarter earnings below expectations and cut its earnings guidance for 2025. Elevance’s earnings in the first quarter were up 14.6% year-over-year.
- CMS suspended enrollment for two Medicare Advantage prescription drug plans offered by eternalHealth, a Boston-based insurer.
- UnitedHealth Group reduced its year-end earnings outlook amid rising use of physician and outpatient services among its Medicare Advantage membership. There could be a link between rising premiums and increasing healthcare utilization, particularly in group Medicare Advantage plans, UnitedHealth executives posited.
