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Humana to Retain Defense Department Contract

Health insurer Humana announced Friday it will retain the Department of Defense’s Tricare contract to provide health coverage for military personnel in the south and their dependents.

Humana previously held the contract, but lost a bid to renew it two years ago. It was instead awarded to the United Health Group. Humana challenged the decision, saying the two companies were not judged according to the same criteria. The award has been re-evaluated, and Humana will once again have the contract.

The Pentagon places the value of the contract at over $23 billion for 5 years.

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Humana Says Earnings Drop Will Have Little Effect

Humana officials say a 57% drop in earnings at the end of last year will not lead to layoffs or other changes in the company.

Humana’s fourth quarter report was slightly below analysts’ expectations, but spokesperson Tom Noland says the drop is not part of a trend.

“The report itself, this particular report, like most reports of this kind, doesn’t have any immediate impact on Louisville one way or the other,” he says.

Noland attributes the drop to various expenses paid in the last quarter, including the acquisition of the healthcare company Concentra. He says overall, 2010 was a good year for the company, and earnings predictions for this year have been increased.

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Zoo Meets Goal For Glacier Run Fundraising

The Louisville Zoo’s fundraising campaign for the Glacier Run exhibit is over due to last-minute donations that helped the zoo secure a matching grant.

In the fall of 2008, the Kresge Foundation promised to donate $900 thousand if the zoo could raise about $8 million by the end of this year.

Director John Walzack says as of last month, the zoo was still several hundred thousand dollars short of that goal.

“These are certainly trying economic times, but we had faith and we are so overwhelmed by the generosity of our community that we just always had a positive outlook that were going to meet this goal,” he says.

Humana and the Ogle Foundation gave two large donations to top off the campaign. The money will go toward two exhibits within Glacier Run, both of which will open in 2012. The polar bear exhibit will open this spring.

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No Agreement Near In Humana, U Of L Physicians Dispute

A months-long stalemate between the University of Louisville Physicians Group and Humana continues. And a resolution in the dispute over reimbursement rates for doctors appears to be far off.

Earlier this year, Humana asked the group to reduce reimbursements for doctors by ten percent under a new contract. The group refused, saying their rates are already too low.

The two sides did not come to an agreement, and in July the group’s contract expired. Now, Humana does not cover many patients’ visits to U of L doctors.

Chair of the surgery department Kelly McMasters says Humana is still unwilling to talk.

“We’ve certainly made an offer to settle the contract negotiation,” he says. “I don’t know if I can give you the details of that but we haven’t really heard back from them, in any meaningful way, that they’re ready to negotiate in good faith.”

A spokesperson for Humana said in a statement that the company is committed to negotiations in good faith, and hopes to find an agreement that is fair to everyone involved.

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UofL Docs, Humana Fail to Reach Agreement

by Stephanie Crosby

Humana and the University of Louisville Physicians group have failed to sign a new contract, and their previous deal expired at midnight.

The doctors’ group says the insurer wants to cut its reimbursement rates by ten-percent and is seeking a ten-percent increase. The physicians says they deserve the raise because they are a group of academic and research-based doctors.

Humana spokesperson Jim Turner says the insurer has tried to treat them as such.

“We at Humana do recognize the U-of-L doctors as an academic medical center,” says Turner. “We provided substantial pay increases to the U-of-L doctors, Humana did, in 2008 and again in 2009, and Humana currently pays the U-of-L doctors rates that are much higher than the Louisville market average.”

But the U-of-L Physicians Group says the rates have to be similar or higher than those in comparable cities with academic medical centers, in order to recruit the best doctors to Louisville.

While no contract exists between the two, patients have the option of seeing another doctor, or paying out-of-network costs for their doctor.

The two groups had a similar coverage gap in 2008 that lasted six months.

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Time is Waning for Deal Between Humana, UofL Doctors

by Stephanie Crosby

Thousands of people could start paying higher rates for care from University of Louisville doctors by Thursday if a new agreement with a local insurer isn’t met.

Humana is in negotiations with about 460 doctors who are members of the U-of-L Physicians Group for a new contract. The current contract ends tomorrow.

U-of-L Physicians vice-president Dr. Allan Tasman says Humana wants to decrease their reimbursement rate by ten-percent.

“Look, we have to pay our mortgages like everybody else,” says Tasman. “All we want to be paid is a fair amount. But the patients are being put in the middle by Humana.”

Tasman says the doctors’ group wants its reimbursement rate increased by ten-percent.

Humana spokesperson Jim Turner says they offered several weeks ago to extend the current contract until a new deal is reached – but that hasn’t been accepted.

“It’s my understanding that they have indicated that they will leave the network on July first,” says Turner, “unless there were any talks between now and Thursday that would result in a new contract.”

If no deal is made, patients who receive care from those doctors and have insurance through Humana will have to find new doctors or pay out-of-network costs.

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UofL Physicians Say They Won't Accept Cut in Insurance Payments

by Stephanie Crosby

Another standoff between doctors and an insurance provider is brewing in Louisville. This time, the dispute involves Humana and the University of Louisville Physicians Group. Their current reimbursement contract ends July first.

Humana informed the group it needs to cut the doctors’ reimbursement rate by ten-percent in the new contract. But the group says it can’t accept a reduction in payments and maintain a comparable rate to other academic medical centers, in order to be able to recruit new doctors.

Dr. Gerard Rabalais says the two sides have been in negotiations, but the insurance company seems unwilling to budge.

“Certainly there are contentious fights that occur between insurers and providers of care, whether they be hospital systems or organizations of physicians,” sasy Rabalais. “The tone of these and the intensity of these are only escalating, not getting better.”

Rabalais says if they are unable to reach an agreement, about twenty-percent of the group’s patients will be out of network.

Humana says in a statement that it has not received a reimbursement proposal from the doctors group.

There was a similar dispute over reimbursement rates last year between Anthem Insurance Co. and Norton Healthcare that was eventually resolved.

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Humana on Health Reform: Costs Will Rise

Private insurers are among those reacting to the passage and likely signing into law of the health care reform bill.  Louisville-based Humana spokesman Tom Noland says the company stands to gain from it by the number of uninsured who will soon be added to the rolls – and have to buy their product.  But Noland says the company’s costs could go up.

“Unfortunately, the bill doesn’t do anything to contain costs, which is the biggest problem in health care.  And in fact the incentives within the bill are going to likely raise costs rather than lower them,” said Noland.

According to the Henry J. Kaiser Family Foundation’s Kaiser Health News, it’s still hard to predict what the legislation could mean for individual and family premiums.  And the efforts that are in the bill to contain rising health care costs may not have much of an effect for years to come.

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Humana Has Extra Year Of Defense Contract

Louisville-based insurer Humana says it’s not yet clear what a contract extension from the U.S. Defense Department will mean for the company.

Earlier this year, Humana lost a bid to continue its contract to provide benefits for service members in the southern United States. The company filed a complaint and the Defense Department agreed to re-evaluate its decision.

In the meantime, the contract has been extended through March 2011. Humana spokesperson Tom Noland says the extension is a positive development, but it’s not yet clear what the extra time will be worth.

“On February 1st, 2010, we will assess quantitatively the impact, or the likely impact—the predicted impact—on the 2010 result of these decisions,” says Noland.

Last year, the contract represented about 11 percent of Humana’s revenue.

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Demonstrators Sit In At Humana

sit in2A group of single-payer healthcare advocates is camped out in the lobby of the Humana building in Louisville.

More than 20 protesters, including Carla Wallace, entered the building at mid-morning.

“We’ll stay here. I guess we’ll just stay overnight. I think this is a life and death issue,” she says. “We want Humana and all the healthcare providers in this country to stop cutting people off who have pre-existing conditions, to stop denying care to the sickest people among us, and to make health care affordable and available for everyone.”

Humana Spokesperson Jim Turner says the group is welcome to stay in the lobby as long as they are peaceful.

Sit In 1

“The folks who come out and demonstrate like this here in Louisville are always very peaceful and respectful and we’ve seen that even in the lobby,” he says.

Turner says Humana also wants to see changes made to the nation’s health care system, but did not elaborate.

Similar protests have led to more than 70 arrests nationwide over the past several months.