UnitedHealth Group's third-quarter medical costs exceeded Wall Street estimates on Tuesday, as the insurer paid out more due to persistently high demand for healthcare services and received lower reimbursements on government-backed insurance plans. Demand for healthcare services under Medicare has surged since late last year as many older adults opted for procedures they had delayed during the pandemic. Shares of UnitedHealth fell 3% in premarket trading after the health conglomerate also trimmed the higher end of its annual adjusted profit forecast by 25 cents to $27.75 per share. The cut was partially due to an increased hit of 10 cents per share from a cyberattack on UnitedHealth's technology unit, Change, in February. The company now sees a business disruption impact of $705 million, or 75 cents a share, this year.
CVS Health and UnitedHealth Group have asked FTC Chair Lina Khan and commissioners Rebecca Kelly Slaughter and Alvaro Bedoya to disqualify themselves from an FTC lawsuit that has accused the companies of unlawfully inflating insulin prices. The companies provided the motions to Reuters after filing them late on Tuesday with the FTC's in-house court. They said that Khan, Slaughter and Bedoya displayed bias against PBMs and prejudged their pricing models. CVS pointed to the commissioners' claims that volume-based discounts, or rebates, lead to higher prices for patients, and to Khan's appearance at a National Community Pharmacist Association event in 2022.
Back-to-back years of increases in premiums have added to the average cost of family coverage, reaching roughly $25,500 this year for employers and workers.
Affiliates of one of the nation's largest Medicare Advantage plans sued the Biden administration claiming that their quality rating was unreasonably downgraded after one customer service phone call. The complaint filed this week by subsidiaries of insurance giant UnitedHealth Group Inc. alleges CMS downgraded the company's 'Star Ratings' based on an 'arbitrary and capricious assessment of how Plaintiffs' call center handled a single phone call that lasted less than ten minutes.' The plaintiffs asked the court to act urgently with an injunction to correct the CMS rating, as open enrollment is set to begin Oct. 15.
A Pennsylvania woman started calling hospitals, doctor's offices, and collection agencies and realized that nobody could tell her what she was paying for and why she was being charged a certain amount. Some bills had been forgiven; some were miscoded. "I was like, I'm not going to just send you $500 for this random you-know-what," says the woman identified as "Catherine." "My takeaway was: Nobody knows what these bills are for." So she did not pay them. She tossed new ones in the trash. She sent unknown numbers straight to voicemail. Getting on top of her debts meant ignoring them.
One of the country's largest providers of private Medicare plans saw its stock sink to its lowest level in 15 years after the federal government cut the rating for one of its most popular offerings. Shares of Humana plunged Wednesday after the company revealed in a filing to the SEC that only 1.6 million people — about a quarter of its members — are signed up for Medicare Advantage plans rated four stars or higher for 2025. This year, 94% of its members are enrolled in them.