Minnesota Attorney General Lori Swanson is asking the federal government to investigate Humana’s Medicare Advantage policies after uncovering what she said were “significant problems” reported by Minnesota patients and medical providers.
Affidavits gathered from 25 Minnesotans showed a pattern where Humana denied claims for medical services required by law, overcharged for co-payments and coinsurance, and failed to disclose the providers that are in the network, she said. Swanson’s office also found that Humana didn’t follow procedures laid out by federal regulations for patients to appeal their cases.
“They were stringing people along, taking months to get back to people,” she said. “Oftentimes, it took the intervention of our office — and oftentimes we had to write multiple times.”
Humana, based in Louisville, Ky., is one of the nation’s largest health care insurers in Medicare Advantage, a private policy that covers seniors and those with disabilities. Humana has been doing business in Minnesota for more than 10 years, and provides insurance coverage to more than 100,000 residents through various types of Humana Medicare Advantage plans, including a plan for prescription drugs, according to a company official.
Humana spokeswoman Kate Marx said in an e-mail that the insurer has not been notified of the complaint by the Minnesota attorney general’s office or by federal regulators.
“We take this very seriously and are working to identify the facts,” Marx said.
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Minnesota attorney general asks U.S. to investigate Humana