Medicare Advantage in the headlines: 9 recent updates

Several mergers and acquisitions are afoot in Medicare Advantage. 

Here are nine updates on the program Becker's has reported since Dec. 19. 

1. Medicare Advantage beneficiaries are more likely to be prescribed biosimilar drugs than their counterparts in traditional Medicare, a study published in JAMA Health Forum found. 
   
   

2. A Medicare Advantage plan jointly owned by Essence Healthcare and Stanford (Calif.) Health Care exited the California market Jan. 1. 
   
   

3. Cigna is nearing a deal to sell its Medicare Advantage business to Health Care Service Corp., according to a Wall Street Journal report. People familiar with the deal told the Journal Cigna is in exclusive talks with HCSC to sell the Medicare Advantage business for between $3 and $4 billion. 
   
   

4. Bright Health closed the sale of its California Medicare Advantage business to Molina Healthcare. The deal will significantly expand Molina's Medicare Advantage business, adding 109,000 members.
    

5. Devoted Health, a startup Medicare Advantage plan, raised $175 million in series E funding. The company has over 140,000 members and expanded to serve 13 states in 2023.
   
   

6. In July, Reps. Michael Burgess, MD, and Vicente Gonzalez, both of Texas, introduced gold card legislation that would exempt qualifying providers from prior authorization requirements for Medicare Advantage plans. Dr. Burgess, a retired OB-GYN, recently spoke to the American Hospital Association about why he is pursuing the bill. 
   
   

7. UnitedHealthcare has at least 75% of the Medicare Advantage market in three major cities, according to the American Medical Association. Here are the cities where UnitedHealthcare had its largest market share in 2022. 
   
   

8. A pair of senators asked CMS to require Medicare Advantage plans to cover stays in long-term care facilities at the same rate as traditional Medicare. 
   
   

9. The Justice Department wants Humana's lawsuit challenging a CMS rule that would implement stricter auditing standards on Medicare Advantage plans moved to a different court, then thrown out. In a Dec. 18 court filing, attorneys argued Humana and its Texas subsidiary, based in Dallas, have no basis to file in the Fort Worth District.