Court upholds CMS decision on Humana Medicare Advantage star ratings amid rising class-action insurance lawsuits involving provider network inaccuracies and insurer duties.
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 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 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.
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 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.
Federal court upholds CMS's star rating methods after Humana challenges foreign language interpreter test policy, impacting Medicare Advantage market competition and insurer revenues.
A U.S. court rejected Humana's attempt to contest the CMS 2025 Medicare Advantage ratings, affecting Humana's bonus payments and highlighting CMS's regulatory role.
Vermont Blue Advantage will discontinue Medicare Advantage plans in 2026, impacting 26,000 enrollees. HealthSpring assumes retiree plans amid market exits by UnitedHealthcare. State braces for enrollment shifts.
CDPHP earns top NCQA and CMS 4.5-star ratings in 2025 for commercial and Medicare health plans, highlighting strong quality and member care in New York's insurance market.
