Through an audit, CMS found Humana did not comply with Medicare requirements, resulting in “delayed or denied benefits that should have been covered or higher out-of-pocket costs,” according to the report.
However, Humana has “swiftly and thoroughly addressed the issues” and “will continue to hold [itself] to the highest standards,” according to Mark Mathis, Humana’s director of corporate communications, in an email to Louisville Business First.
To mitigate future recurrence, Humana has made technology upgrades, implemented new processes for reporting benefits and increased staff training efforts. Over the course of the next few months, Humana will conduct an independent audit of these changes and report the information to CMS.
More articles on payer issues:
How much did Humana’s CEO make in 2015?
NC insurance commissioner: BCBS could be fined up to $1k per day per violation
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