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…
Medicare Advantage
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…
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CMS Administrator Mehmet Oz, MD, told FOX 5 Atlanta that the government shutdown is not affecting Medicare open enrollment. “The shutdown is a problem for lots of parts of government but not for [Medicare] open enrollment,” he said. “Medicare is…
Johnson City, Tenn.-based Ballad Health is suing UnitedHealth Group for alleged “Medicare Advantage manipulation” that has led to denied care and underpayment for services. The lawsuit was filed Oct. 21 in a Tennessee federal court and claims that UnitedHealth’s actions…
Medicare open enrollment kicked off earlier this month and will run until Dec. 7. From some big players exiting Medicare Advantage to boosts in regulatory legislation, there has been more uncertainty with navigating the space. Becker’s caught up with six…
CMS Administrator Mehmet Oz, MD, discussed some of the biggest issues facing the Medicare Advantage program at an Oct. 15 industry conference. During his first six months on the job, CMS has already overseen policy moves to streamline prior authorization…
Following the kickoff of Medicare open enrollment on Oct. 15, The Washington Post discovered inconsistencies in the Medicare Plan Finder, such as duplicative addresses and contradictory information regarding providers’ network status. After the Post reported the issues to CMS, an…