SCAN Health Plan has emerged as a major Medicare Advantage partner for retailers, with Walmart now partaking in a co-branded plan. The health insurer and retailer are launching the plan in two states, according to a Sept. 16 SCAN news…
Medicare Advantage
Humana and UnitedHealthcare received a combined total of $177.8 million in Medicare Advantage overpayments tied to coding that was not supported by medical records, the HHS Office of Inspector General said in separate audit reports published Sept. 15. The OIG’s…
Medicare Advantage now covers more than 51% of eligible beneficiaries, but for a growing number of health systems, participating in the program has become a lose-lose proposition: stay in and absorb mounting losses, or exit and hand competitors an enrollment…
HHS’ Office of Inspector General released a report in September detailing gaps in efforts to reduce or halt medical equipment supplier fraud in Medicare Advantage. Earlier in the month, CMS announced that it had barred 11 medical suppliers from receiving…
A federal judge has dismissed Ballad Health’s lawsuit accusing UnitedHealth Group of denying and underpaying Medicare Advantage claims, ruling the dispute must go to arbitration. Johnson City, Tenn.-based Ballad sued UnitedHealth in October, alleging the insurer spent years denying valid…
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As insurers and provider-sponsored health plans reassess their exposure to Medicare Advantage, Detroit-based Henry Ford Health is moving in the opposite direction. Medicare Advantage enrollment at Health Alliance Plan by Henry Ford Health surged 45.8% year over year to 132,566…
UnitedHealth Group says its Medicare Advantage business is outperforming initial margin targets for 2026, crediting deliberate financial recovery moves that meant fewer members this year. Speaking at a Wells Fargo conference Sept. 9, CFO Wayne DeVeydt said the company “really…
Beginning Oct. 1, Mass General Brigham Health Plan will remove Dana-Farber Cancer Institute from its Medicare Advantage network. MGB Health Plan operates and makes network decisions “separately, independently and without influence from” the Somerville, Mass.-based Mass General Brigham, according to…
CMS has been cracking down on possible fraud with medical equipment suppliers for months, sharing two major updates in recent weeks. CMS announced that it is barring 11 medical supply companies focused on durable medical equipment, prosthetics, orthotics and supplies…
In August, SCAN Health Plan announced a partnership with Costco Wholesale Corp. to sell insurance products for older adults. Sound familiar? Costco is not the first retailer to partner with a Medicare Advantage insurer. Kroger has worked with Select Health…