Update on Payment Policy Regarding Claims for Medicare-eligible Commercial Members

Policy update

Based on recent guidance from the Centers for Medicare & Medicaid Services (CMS), Humana will discontinue implementation the payment reduction policy for members eligible for Medicare benefits and not enrolled. Therefore, Humana will not reduce its members’ benefits by the expected amount covered under Medicare Part B beginning July 1, 2016, as previously communicated in the April 2016 Humana’s YourPractice newsletter. This payment policy would have affected physicians and health care providers who provide services for commercial fully insured Humana members.

The previous article stated there would be a change in Humana’s payment policy. This policy would have applied Medicare benefits for members eligible for Medicare Part B who are not currently enrolled in situations where Medicare would be primary if they had enrolled.