Radar on Medicare Advantage

Medicare Advantage Enrollment Soars Past 26 Million in Latest AEP

Approximately 2.4 million people enrolled in a Medicare Advantage plan from February 2020 to February 2021, bringing the total MA population to 26.3 million medical lives. That’s a 9.9% year-over-year increase, ac...
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Becerra Testimony Hints At Hard Line on Drug Prices, Medicare Advantage Payments

As policymakers consider proposals to revamp Medicare Part D, HHS secretary nominee and California Attorney General Xavier Becerra (D) during his Senate confirmation hearings last week vowed to make reducing the cos...
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News Briefs

✦ In its first earnings report released as a publicly traded company, Clover Health on March 1 said it ended 2020 with more than 58,000 Medicare members, generated more than $670 million in revenue for the full y...
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‘Unusual’ Humana Case Has Implications for Pharma Pacts

In what the plaintiff’s attorneys are calling the first False Claims Act settlement arising from a Medicare Advantage organization accepting a kickback from a pharmaceutical company, Humana Inc., Roche Diagnostics...
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With Switching Down, MAOs Seek ‘Untapped’ Market Segments

Recent data from the 2021 Medicare Annual Election Period (AEP) reflects the anticipated increase in Medicare Advantage enrollment, which is up 9.8% from a year ago and indicates penetration exceeding 43%, according...
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Care Deferrals Pose Headwinds For MA Risk Adjustment in ’21

Although many publicly traded insurers touted enrollment growth from the 2021 Medicare Annual Election Period (AEP) when reporting fourth-quarter and full-year 2020 earnings, some expressed the concern that care def...
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2021 Flex Benefits Show COVID Influence, Insurer Comfort

Last year, Medicare Advantage plans for the first time were able to extend a variety of non-primarily health-related items and services to their chronically ill beneficiaries, but insurer adoption of these benefits ...
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News Briefs

✦ President Joe Biden at press time was expected to name Chiquita Brooks-LaSure as the new CMS administrator, according to multiple news reports. Currently a managing director with Manatt Health, Brooks-LaSure i...
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Biden Kicks Off Presidency With Medicaid, Rebate Rule Actions

In a series of steps that were largely expected, the Biden administration in its early days moved to revisit policies approved by the prior administration that it views as weakening Medicaid and Affordable Care Act ...
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2021 Outlook: As Audits ‘Return to Normal,’ MAOs Could Face Tougher CMS

The Trump years were noticeably light on Medicare Parts C and D program enforcement — and 2020 in general was a departure from normal operations — but as CMS resumes program audits and other oversight activities...
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