The lawsuit names Aetna, Cigna, UnitedHealthcare, Humana, Elevance Health, Molina Healthcare, Centene and Health Care Service Corp. as defendants. The Arizona case adds to a growing body of litigation surrounding MultiPlan's out-of-network reimbursement practices.
According to Arizona's complaint, insurers allegedly shared...News
Medicare Advantage enrollment continues to grow and now covers 51.8% of all Medicare-eligible beneficiaries, yet despite 301 insurers participating in the market, enrollment remains heavily concentrated among a small group of national carriers. Nearly 78% of MA beneficiaries are enrolled in plans operated by just 10 insurers, with...National News
Humana will move forward on cutting supplemental benefits offered in its Medicare Advantage in response to a lower-than-expected base payment increase in federal reimbursement and a difficult first quarter due to a lower 2026 Medicare Advantage Star Rating.
Earlier this month, the Centers for Medicare and Medicaid Services (CMS)...
The Centers for Medicare & Medicaid Services (CMS) on Monday finalized a stronger-than-expected payment update for Medicare Advantage (MA) plans in 2027, backing off from an earlier proposal from the agency that signaled flat funding, which triggered industry concern over benefit cuts and market exits.
CMS said the final rate...
Nearly 787,000 Arizona beneficiaries began 2026 enrolled in Medicare Advantage (MA), according to CMS January enrollment files — only a modest increase from roughly 780,058 enrollees in June 2025. The muted membership gain suggests growth may be slowing in a national and local market that this year remains flat at about 51%...
While most insurers are downsizing their Medicare Advantage market presence, Humana is doubling down and acquiring healthcare services to support its expanding network.
Last week, Humana's CenterWell Senior Primary Care, a value-based care provider, completed the acquisition of MaxHealth from Arsenal Capital Partners (Arsenal), a...National News
Three national insurers delivered earnings this week that, when taken together, sketch a market still adjusting to higher medical cost trends and shifting program economics.
Humana’s update centers squarely on Medicare Advantage (MA). The company reported fourth-quarter revenue of $32.5 billion and full-year revenue of $129.7...National News
It has been a tough year for insurers in the Medicare Advantage market. After years of threatening to exit the market if profits plateaued, companies like Humana, CVS Health and UnitedHealthcare are planning to recoup losses by cutting benefits and leaving lower-yield markets.
Humana and CVS moved to scale back their Medicare...
Get the latest on national and Arizona Medicare Advantage (MA) enrollment in The Hertel Report's annual MA Data Edition. Learn about Arizona's top-performing MA plans, enrollment leaders, MA market penetration, and our popular MA enrollment by Arizona county and more!
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Medicare Advantage insurers are having a tough time. Humana was forced to refile its lawsuit against the Centers for Medicare and Medicaid Services (CMS) over inappropriate star ratings awards as it scales back its use of prior authorizations. Meanwhile, the American Hospital Association (AHA) testified in Congress about the problems...
The Centers for Medicare & Medicaid Services (CMS) conducts Risk Adjustment Data Validation (RADV) audits to ensure diagnoses used to determine Medicare Advantage (MA) payments are backed by medical records; federal estimates suggest MA plans may overbill the government between $17 to $43 billion a year. The agency now pledges to...
Despite covering 5.8 million Medicare Advantage (MA) enrollees—second only to UnitedHealthcare—Humana was the only major insurer to avoid significant first-quarter losses tied to the MA program.
Humana left Medicare Advantage markets in 13 counties in 2025, affecting about 560,000 members—roughly 10% of its MA enrollment, and...
Medicare Advantage (MA) enrollment in 2025 has reached 34.4 million, an increase of about 1 million from last year, or just 4%, a slow gain over previous years.
Three insurers—UnitedHealth Group’s UnitedHealthcare, Humana, and CVS Health’s Aetna—continue to dominate the MA market. UnitedHealthcare, the nation’s largest MA...
With normal communications from CMS suspended, no January 2025 enrollment totals are available. Instead, The Hertel Report compiled end-of-year (EOY) Arizona Medicare Advantage enrollment totals and market penetration, as well as the agency's December 2024 dump of monetary sanctions against Elevance, Centene, and Humana, including plans...
After years of churning in the rumor mill, the Cigna Group has directly stated that it is not pursuing a merger or acquisition with Humana Inc.
The two companies began talks for a potential merger late last year, but the discussion was tabled after they were unable to reassure investors. Earlier this fall, rumors reignited that the...Arizona News
The National Association of Insurance Commissioners report provides financial and market intelligence on the insurance industry - another tool for insurers to identify their competitors and comparative market share. The Hertel Report collected the top 10 leaders in Arizona including UnitedHealth Group, Blue Cross Blue Shield of Arizona...National News
Humana's rough patch continues as it sues the U.S. Department of Health and Human Services over star ratings and revisits a potential merger with Cigna.
This month, Humana reached a $90 million settlement with the United States over allegations of fraudulent bids submitted to the Centers for Medicare and Medicaid Services (CMS) for...
On Thursday, the Senate Homeland Security Permanent Subcommittee on Investigations (PSI) published a report on Medicare Advantage denials for post-acute care services. The study showed that the three largest Medicare Advantage insurers, UnitedHealthcare, Humana and CVS Aetna, significantly raised the rate of prior authorization denials...
More than 67 million Americans are Medicare-eligible. This month, as Medicare Advantage (MA) plans promote low co-pays and extra benefits to potential enrollees, plan sponsors are pushing back against CMS's cuts to star rating bonuses. Meanwhile, a former CMS official advises stricter regulation of MA plans as they continue to woo...National News
Changes to the Medicare Advantage star ratings calculation are already having major impacts for insurers and their shareholders as Humana saw its stocks plunge after announcing that only a quarter of its members are enrolled in plans rated four stars or higher for 2025.
The Centers for Medicare and Medicaid Services (CMS) awards star...
