- UnitedHealth Group Inc. pledged to reprocess every one of its commercial claims tied to COVID-19 vaccines. The promise comes after a federal investigation uncovered that the Minnesota-based insurer doled out “millions” in provider bills at a rate 40 percent less than what was stipulated through Medicare. UnitedHealth will owe providers $15 million for every 1 million claims it reprocesses, and is responsible for notifying the Senate Aging Committee of how much it owes and to whom by November 5. (Article here)
- A new analysis estimates that Medicare Advantage (MA) provides beneficiaries $32.5 billion a year in additional benefits and lower out-of-pocket costs. The analysis found that 75 percent of MA the payments are spent on hospital and provider services and the remaining 25 percent go toward additional benefits, lower cost-sharing, and premiums. The researchers estimated the value of reduced cost-sharing and additional benefits at $123 per member per month, equating to $32.5 billion for the approximately 22 million MA beneficiaries. (Article here)
October 22, 2021
Payers