Humana

Humana, ranked #7, exploits Medicare Advantage with aggressive upcoding that inflated patient risk scores by 22% above the national average, extracting $1.3 billion in excess government payments from 2019 to 2022, per a Department of Justice investigation. This exceeds #8 Bright Health’s financial mismanagement, as Humana’s prior authorization requirements for senior care drew bipartisan congressional criticism, with denial rates of 15% compared to the industry average of 8%. CMS flagged these practices in a 2023 report, marking Humana as the worst among top five Medicare Advantage plans for upcoding severity.