United Healthcare’s random 30% claim denial rate caused a drop in its consumer quality ranking and reimbursement rate. CMS has dropped its appeal in the case and will allow the fraud to continue unexamined.
Give them what they voted for – good and hard
intercst
Yup. The health insurers flew today. HUM also has a case in process disputing it’s lousy star rating. The big picture takeaway is that quality of service is no longer a priority for CMS. iirc, the star rating a company receives impacts the reimbursement rate from CMS, so CMS no longer contesting low star ratings means everyone will trend to the highest ratings and the highest reimbursement level.
There was also chatter, a couple weeks ago, that a big bump in Medicare Advantage reimbursement rates is in the works.
Wonder how much the insurance industry “donated” to win all this?
Steve