Kelsey-Seybold team to expand Humana’s Medicare Advantage provider network

Major insurance hub Humana has partnered with multi-specialty group practice Kelsey-Seybold Clinic to sign an in-network agreement that Humana hopes will allow expanded access to value-based care through a broadening of its Medicare Advantage provider network in the Houston area. The insurer expects the move will expand access to care to include members of its Medicare Advantage HMO plans.

With this agreement that becomes effective Jan. 1, 2022, Houston-area members of Humana Medicare Advantage HMO plans will have in-network access to care at more than 26 convenient Kelsey-Seybold Clinic locations. They also will have access to more than 500 providers in 55 medical specialties across the Houston-Galveston region.

Humana has stressed that the new relationship will emphasize the insurer’s focus on value-based care, as well as access to proactive health screenings and programs focused on preventing illness.

The insurer has also promised to leverage technologies such as data analytics to connect physicians and facilitate coordination of care. They have also said it expects improved care for people living with chronic conditions.

Humana also said that solid fundamentals across its business lines have played a part to navigate the impacts of the coronavirus pandemic.

CMS Final Rule Extends Marketplace Open Enrollment to January 15, 2022

 

On September 17, 2021, the Centers for Medicare & Medicaid Services (CMS) finalized changes that follow through on President Biden’s promise to build on the Affordable Care Act and expand health coverage access for Americans. The changes are the third installment of the payment notice for 2022.

 

There are many important policy updates that Marketplace agents and brokers should be aware of prior to the beginning of the plan year 2022 Open Enrollment Period (OEP). These include:

• An extension of the OEP is extended from November 1, 2021, to January 15, 2022, annually for Marketplaces on the federal platform.

• Clarification for Special Enrollment Period (SEP) rules regarding enrollees who qualify for a maximum advance premium tax credit (APTC) amount of zero dollars.

• A monthly SEP for APTC-eligible individuals whose household income does not exceed 150 percent of the federal poverty level (FPL).

• Clarification on the full range of Direct Enrollment (DE) and Enhanced Direct Enrollment (EDE) options available for OEP.