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Humana Questions Medicare Assumptions

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The Centers for Medicare and Medicaid Services is assuming that physicians who treat Medicare Advantage plan patients will accept a 20% pay cut in 2010.

Humana Inc., Louisville, Ky., discusses that CMS assumption and others in a comment on the preliminary 2010 CMS Medicare Advantage payment rate schedule.

CMS expects to release the final rates April 6.

The assumptions incorporated in the preliminary rates seem “to be unusual and inconsistent with decades of experience and with past CMS practice,” Humana says. “In addition, the rates as announced would have a significant adverse impact on 2010 premiums and benefits for Medicare Advantage members if these rates become final.”

The health insurance industry will be joining together to submit a formal comment on the CMS rate announcement, Humana says.


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