Minnesota Asks CMS to Investigate Humana’s Medicare Advantage Plans

Minnesota Attorney General Lori Swanson has asked CMS to investigate how health insurer Humana administers its Medicare Advantage policies in response to issues reported by beneficiaries and providers, according to a Star Tribune report.

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Humana provides coverage to more than 100,000 Minnesota residents through various Medicare Advantage plans, which offer beneficiaries Medicare coverage through policies administered by a private insurer. Ms. Swanson has collected affidavits from 25 state residents who have reported the health insurer denied claims for medical services that should have been covered, overcharged through copays and coinsurance and didn’t disclose whether or not providers were in a plan’s provider network, according to the report.

Ms. Swanson’s office has also alleged Humana failed to follow federal regulations regarding procedures for patients appealing their cases, according to the report.

Humana hasn’t been notified of the complaint by federal regulators of the Minnesota attorney general’s office, spokeswoman Kate Marx said in an email to the Tribune. The insurer takes the allegations very seriously and is “working to identify the facts,” according to Ms. Marx.

More Articles on Medicare Advantage:
Medicare Advantage Not Hurt So Far by PPACA Cuts
Analysis: Number of Medicare Advantage Plans to Drop 5.3% in 2014
6 Key Facts About Medicare Beneficiaries’ Finances 

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