By Jakob Emerson Becker’s Hospital Review, September 27, 2023 Medicare Advantage provides health coverage to more than half of the nation’s seniors, but a growing number of hospitals and health…
Fraud is rampant in Medicare Advantage
Op-Ed: Fraud Is Rampant in Medicare Advantage — Enforcing the False Claims Act can help
…time? According to private insurers participating in the Medicare Advantage program, the answer is yes. The data architecture of Medicare Advantage is vulnerable to fraud perpetrated by the Medicare Advantage…
Medicare Advantage is Plundering Medicare: Expansion Would Be Disastrous
Summary: A JAMA viewpoint published in December advocated Medicare Advantage for All, ignoring the sordid record of Medicare Advantage plans. Those plans extract tens of billions in profits, avoid and…
Robert Kuttner explains the irrationality of Harris’ inclusion of Medicare Advantage
Harris’s Fake Medicare-for-All Plan
…the real meaning of “Medicare Advantage.” Advantage: industry. Disadvantage: consumers and patients. According to some, many seniors like Medicare Advantage, and so it would be folly for Democrats to kill…
Government endorses Medicare Advantage upcoding fraud
CMS pitches 1.1% boost to Medicare Advantage payments By Bob Herman Modern Healthcare, February 20, 2015 The CMS has proposed increasing health insurers’ Medicare Advantage payment rates by 1.05% for…
Lesson for Congress: Medicare Advantage
…report found: From 2005 through 2008, the average Medicare Advantage insurer spent over 15% of premium revenue on profits, marketing, and other corporate expenses. Two-thirds of the Medicare Advantage insurers…
Lesson for Congress: Medicare Advantage
New Report Highlights Medicare Advantage Insurers’ Higher Administrative Spending
…Advantage insurer spent over 15% of premium revenue on profits, marketing, and other corporate expenses. Two-thirds of the Medicare Advantage insurers surveyed by the Committee had a medical loss ratio…
More Medicare Advantage audits reveal overcharges
…place with respect to Medicare Advantage plans and will continue working to increase oversight and accountability in this area,” said McCaskill spokesman Drew Pusateri. This story was co-published with NPR. http://www.publicintegrity.org/2015/07/10/17634/more-medicare-advantage-audits-reveal-overcharges…
More evidence of squishy risk adjustment for Medicare Advantage
…score,” which is intended to pay Medicare Advantage insurers higher rates for taking sicker people and less for those with few medical needs. http://www.publicintegrity.org/2015/05/29/17422/mccaskill-medicare-advantage-billing-fraud-must-be-investigated **** Comment: By Don McCanne, MD…
Medicare Advantage as a precursor of premium support
Variations In County-Level Costs Between Traditional Medicare And Medicare Advantage Have Implications For Premium Support By Brian Biles, Giselle Casillas and Stuart Guterman Health Affairs, January 2015 Abstract Concern about…
Obama administration intervenes to give $71.5 billion to overpaid, for-profit Medicare Advantage plans
…of Trustees to calculate the impact of a 5.5 percent hike in Medicare Advantage payments on insurers’ stock valuation and future government spending. Hellander said, “Medicare Advantage plans are siphoning…
Curbing Medicare Advantage Overpayments Would Strengthen Medicare
…legislation is also expected to modestly reduce the sizable overpayments now being made to private insurance plans that participate in the Medicare Advantage program. (In July, the House voted to…