Humana has agreed to continue some terms from a class action lawsuit settlement agreement after the agreement expired in October 2009. These terms include:
- Ninety days' written notice before implementing fee schedule reductions and other “material adverse changes”
- Use of the clinical definition of medical necessity as outlined in the settlement agreement
- Use of the coding rules required by the settlement agreement
- Eighteen-month limit on overpayment recovery
Humana covers more than 18,500 Pennsylvanians in 65 counties.
Humana executives agreed to continue these terms after a meeting with the Physicians Advocacy Institute and attorneys from several state medical associations.
Visit the American Medical Association website for a list of the terms that will continue, and then make sure that Humana continues to abide by these terms.