Buy Humana Health Insurance

The exit of Humana Inc. from the employer health insurance market may foreshadow difficult decisions ahead for large insurers as they face greater scrutiny on costs from companies while being lured by the more lucrative Medicare Advantage market.

buy humana health insurance

Humana announced Feb. 23 that it will phase out its commercial business with employer health plans over the next 18 to 24 months to focus on its core government business, primarily operating private Medicare plans known as Medicare Advantage.

Pressure on health insurers continues to grow as employers seek to curb soaring health-care costs, demanding access to their claims data and in some cases suing to get it. Fortune 500 company Owens & Minor Inc. this month sued an Anthem Blue Cross affiliate, saying the insurer had repeatedly refused to turn over claims data requested since 2021.

Over the long term, that will likely lead to less variation in health-care costs, Thompson said. Currently, there can be wide variations in prices employers pay hospitals and health-care providers in the networks set up by insurers.

A Humana Inc. health plan for seniors in Florida improperly collected nearly $200 million in 2015 by overstating how sick some patients were, according to a new federal audit, which seeks to claw back the money.

Now the OIG is rolling out a series of audits that could for the first time put health plans on the hook for refunding tens of millions of dollars or more to Medicare. The OIG is planning to release five to seven similar audits within the next year or two, officials said.

The Humana audit, conducted from February 2017 to August 2020, tied overpayments to medical conditions that pay health plans extra because they are costly to treat, such as some cases of cancer or diabetes that have serious medical complications.

Auditors examined a random sample of 200 patients' medical charts to make sure the patients had the diseases the health plans were paid to treat, or that the conditions were as severe as the health plan claimed.

In the end, auditors said Medicare overpaid Humana by $249,279 for the 200 patients whose medical charts were closely examined in the sample. Based on those 200 cases, auditors used a technique called extrapolation to estimate the prevalence of such billing errors across the health plan.

The OIG notified Humana of its findings in September 2020, according to the audit. A final decision on collecting the money rests with the Centers for Medicare & Medicaid Services, or CMS, which runs Medicare Advantage. Under federal law, the OIG is responsible for identifying waste and mismanagement in federal health care programs but can only recommend repayment. CMS had no comment.

Medicaid, too, has been a boon to health insurance companies since the Affordable Care Act was signed into law in 2010 by then President Barack Obama. The law provided more generous federal dollars toward Medicaid for poor Americans so states that administer such health coverage could expand it for more Americans.

I am a scientist, businessman, author, and philanthropist. For nearly two decades, I was a professor at Harvard Medical School and Harvard School of Public Health where I founded two academic research departments, the Division of Biochemical Pharmacology and the Division of Human Retrovirology. I am perhaps most well known for my work on cancer, HIV/AIDS, genomics and, today, on COVID-19. My autobiography, My Lifelong Fight Against Disease, publishes this October. I am chair and president of ACCESS Health International, a nonprofit organization I founded that fosters innovative solutions to the greatest health challenges of our day. Each of my articles at Forbes.com will focus on a specific healthcare challenge and offer best practices and innovative solutions to overcome those challenges for the benefit of all.

I am a physician, speaker, and writer, focusing on the intersections of healthcare, digital innovation, and policy. I completed an M.D./ J.D. dual-degree with distinguished honors. I was previously a strategy consultant for a global consulting firm, where I advised large corporations on enterprise performance and workflow success. I have focused my scholarship and work on how systemic changes to healthcare affect the realities of actual patient care and societal health outcomes. Specifically, I draw upon my clinical training, legal education, and background in strategy to analyze the operational, business, and political frameworks that impact clinical medicine, innovation in healthcare, and health policy. I am an avid reader of non-fiction books, and enjoy writing, public speaking, and biking in my free time.

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I'm a former correspondent for award-winning health policy publication, the Health Service Journal. My work exposing PPE shortages in hospitals during the pandemic was recognized as \"Excellence in Reporting Coronavirus\" by Press Gazette. I've been a journalist for seven years and have also written for Newsweek and Metro.co.uk.

I am a physician with long-standing interests in health policy, medical ethics and free-market economics. I am the co-founder of Freedom and Individual Rights in Medicine (FIRM). I graduated from University of Michigan Medical School and completed my residency in diagnostic radiology at the Washington University School of Medicine in St. Louis (where I was also a faculty member). I'm now in private practice in the Denver area. All my opinions are my own, and not necessarily shared by my employer. 041b061a72