The Humana world headquarters building in downtown Louisville, Kentucky. Photo: Katherine Welles/Shutterstock.com

CMS Star Ratings Upheld in Humana Medicare Advantage Lawsuit; Class Actions Impact Insurer Litigation

Court upholds CMS decision on Humana Medicare Advantage star ratings amid rising class-action insurance lawsuits involving provider network inaccuracies and insurer duties.

Growth in Special Needs Plans (SNPs) Drives Medicare Advantage Enrollment

Special Needs Plans (SNPs) are driving significant growth in Medicare Advantage enrollment in 2025, with chronic condition and dual-eligible SNPs leading gains. Institutional SNPs decline amid evolving care models.

FirstMedicare Direct to Exit Medicare Advantage Market, Impacting 6,000 Members

FirstMedicare Direct will close operations by end of 2025, affecting 6,000 Medicare Advantage members. This exit highlights challenges in the Medicare Advantage insurance market.

Medicare Advantage Shifts Focus From Growth to Profitability Amid Regulatory Changes

Medicare Advantage market pivots from growth-at-any-cost to profitability-first amid CMS regulatory tightening and rising medical costs. Key strategic shifts include operational efficiency, agility in member services, and investment in clinical programs to improve outcomes and reduce total care costs.

Medigap Plans F, G, and N: Key Insights for U.S. Insurance Professionals

Explore essential insights into Medigap Plans F, G, and N, focusing on coverage, enrollment periods, and regulatory nuances critical for U.S. insurance professionals advising Medicare beneficiaries.

Community Paramedics Reduce Hospital Readmissions Under Medicare Penalties

Community paramedics and post-discharge monitoring reduce hospital readmissions and Medicare penalties, improving patient outcomes and cost efficiency in Minnesota hospitals.

Gulf South States Rank Lowest in 2025 Medicare Scorecard for Access and Quality

The 2025 Commonwealth Fund Medicare Scorecard ranks Gulf South states lowest nationally due to challenges in access, quality, costs, and population health for older adults and disabled Medicare beneficiaries.

Medicare Advantage Contraction in Rural Oregon Highlights Market Sustainability Challenges

Samaritan Health Plans exits Medicare Advantage in Lincoln County, Oregon, leaving Devoted Health as sole 2026 provider. Insights on market sustainability, special enrollment, and resources for seniors.

Medicare Part B Premiums Rise in 2026; Part D Drug Costs Slightly Decline

Medicare Part B premiums are set to rise significantly in 2026 amid medical inflation, while Part D prescription drug costs slightly decline nationally. Enrollment opens October 15 for plan changes including Medicare Advantage and Medigap options.

Judge Upholds CMS Star Rating Methodology in Humana Medicare Advantage Dispute

Federal court upholds CMS's star rating methods after Humana challenges foreign language interpreter test policy, impacting Medicare Advantage market competition and insurer revenues.