…suggested building a national health insurance program on Medicare Advantage rather than on the traditional fee-for-service Medicare program. “Medicare Advantage for all — that would be a much more politically…
Medicare Advantage Employer Group Waiver Plans (MA-EGWPs)
Continued Enrollment Growth in Employer-Group Medicare Advantage
…for Medicare. Medicare Advantage plans can either be acquired individually through direct purchase policies or through employer/group retiree programs, commonly known as Medicare Advantage Employer Group Waiver Plans (MA-EGWPs). Since…
PPO becomes PP-No: Providers Refuse Medicare Advantage
Hospitals and provider systems are increasingly opting out of Medicare Advantage (MA) networks, frustrated by low payment rates and rising payment denials. Even “preferred provider” MA plans, which should cover any Medicare provider, are being declined by prestigious health systems.
…not alone — at least a half-dozen other health systems around the U.S. are terminating Advantage contracts. … [T]he Scripps Health decision underscores an important downside to Medicare Advantage plans:…
Medicare Advantage vs Traditional Medicare for Acute MI
…90-day revascularization rates between Medicare Advantage and traditional Medicare. [Utilization] Rates of guideline-recommended medication prescriptions were … higher in Medicare Advantage (91.7%) vs traditional Medicare patients (89.0%)…. Medicare Advantage patients…
Medicare Advantage Plans Often Deny Needed Care, Federal Report Finds
Investigators urged increased oversight of the program, saying that insurers deny tens of thousands of authorization requests annually.
By Reed Abelson New York Times, April 28, 2022 Every year, tens of thousands of people enrolled in private Medicare Advantage plans are denied necessary care that should be covered…
Medicare Advantage plans padded charges on home visits, whistleblower says
…privately-run Medicare Advantage plans that have proven increasingly popular with senior citizens. The latest lawsuit was filed in federal court in Dallas by Becky Ramsey-Ledesma, a medical billing coder, against…
Company Behind Joe Namath Medicare Advantage Ads Has Long Rap Sheet of Misconduct
The firm formerly known as Benefytt pocketed millions selling sham insurance to seniors and other consumers.
…how great their life would be if only they signed up for a Medicare Advantage plan. From October 15 to December 7 last year alone, Joe Namath ads ran 3,670…
Medicare Advantage as the true Medicare? Rhetoric won’t make it so
Creating Medicare Advantage Premium Support For All, Part 5: Which Proposal Is Actually Medicare?
…private Medicare Advantage plans restrict by use of provider networks – out-of-pocket expenses are still too high, especially considering the lack of a cap on those expenses. Private Medicare Advantage…
Insurers take advantage of Medicare funds
…you think the “advantage” will be yours. What is Medicare Advantage? Traditional Medicare as created in 1965 was a simple and effective system. Millions of seniors no longer had to…
One way Medicare Advantage plans game risk scores
…according to the suit. http://www.publicintegrity.org/2014/10/29/16095/another-whistleblower-suit-alleges-medicare-advantage-fraud **** Comment: By Don McCanne, MD Assuming the allegations of this lawsuit prove to be true, it appears that private Medicare Advantage insurers contracted with…
CMS not fulfilling obligation to recover Medicare Advantage overpayments
Auditors: feds failed to rein in billions in over-billing by Medicare Advantage By Fred Schulte The Center for Public Integrity, May 9, 2016 Private Medicare Advantage plans treating the elderly…
CMS not fulfilling obligation to recover Medicare Advantage overpayments
Auditors: feds failed to rein in billions in over-billing by Medicare Advantage By Fred Schulte The Center for Public Integrity, May 9, 2016 Private Medicare Advantage plans treating the elderly…