Tag Archives: Medicare Advantage

As Scandals Mount, So Do Calls to Abolish Private Medicare Advantage Plans

“Problems with Medicare Advantage are systemic and widespread,” said Rep. Pramila Jayapal. “Not only do they too often deny care—they’re ripping off taxpayers.”

By Brett Wilkins.  Published 12-13-2022 by Common Dreams

Photo: K Whiteford/Public domain

As yet another scandal involving Medicare Advantage made headlines this week, progressive U.S. lawmakers and advocates renewed calls to abolish the private health insurance program that a recent Senate report said is “running amok” with “fraudsters and scam artists.”

In a new Nation article written with health insurance reform advocate Wendell Potter, Reps. Ro Khanna (D-Calif.) and Mark Pocan (D-Wis.) contend that one of the most confusing things facing elders while choosing their Medicare plans “is a scheme by private insurance companies to prey on seniors and profit off of the Medicare brand, all in the name of padding their corporate profits and shareholder returns.” Continue reading

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Austin AFL-CIO Council Becomes Latest to Urge Biden to End Medicare Privatization Scheme

The labor council’s newly passed resolution warns that the scheme “allows doctors and their offices to convert a patients’ traditional Medicare choice into ACO-REACH coverage without first informing their patients.”

By Jake Johnson  Published 11-21-2022 by Common Dreams

Health and Human Services Secretary Xavier Becerra. Photo: Gage Skidmore/flickr/CC

The labor council of the Austin, Texas AFL-CIO has passed a resolution urging the Biden administration to terminate a Medicare privatization scheme that is quietly moving ahead despite vocal opposition from doctors, seniors, and progressive lawmakers.

The pilot program, which inserts private middlemen between patients and healthcare providers, was unveiled with little notice during the final months of the Trump administration despite internal concerns about its legality. The experiment has since been largely upheld by the Biden administration, which announced mostly cosmetic changes earlier this year, winning applause from industry groups that lobbied against complete elimination of the program. Continue reading

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‘Straight Up Fraud’: Data Confirms Private Insurers Use Medicare Advantage to Steal Billions

“The move to privatize Medicare,” said one expert, has “been very profitable, in part because insurers are good at making their patients seem sicker.”

By Kenny Stancil  Published 10=9-2022 by Common Dreams

Photo: K Whiteford/Public domain

Insurance giants are exploiting Medicare Advantage—a corporate-managed program that threatens to result in the complete privatization of traditional Medicare—to capture billions of dollars in extra profits, Saturday reporting by The New York Times confirmed.

The newspaper’s analysis of dozens of lawsuits, inspector general reports, and watchdog investigations found that overbilling by Medicare Advantage (MA) providers is so pervasive it exceeds the budgets of entire federal agencies, prompting journalist Ryan Cooper to call the program “a straight up fraud scheme.” Continue reading

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‘Staggering’: Watchdog Finds Medicare Advantage Plans Deny Necessary Care

“These plans are designed to maximize profits for corporations, NOT to provide high-quality healthcare,” said Social Security Works.

By Jessica Corbett  Published 4-28-2022 by Common Dreams

Photo: Myfuture.com/flickr/CC

A government watchdog revealed Thursday that Medicare Advantage plans—which are offered by private companies but required to follow rules set by the government healthcare program—deny medically necessary care to tens of thousands of enrollees each year.

The revelation came in a report released by the U.S. Department of Health and Human Services Office of Inspector General (OIG), which examined a random sample of 250 prior authorization denials and 250 payment denials issued by 15 of the largest Medicare Advantage Organizations (MAOs) during the first week of June in 2019. Continue reading

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Advocates Sound Alarm Over Quiet Trump Era Move That Could Further Privatize Medicare

“The Biden administration should immediately kill this toxic legacy of the former president.”

By Jake Johnson, staff writer for Common Dreams. Published 3-13-2021

Seema Verma, administrator of the Centers for Medicare and Medicaid Services during the Trump administration. Photo: Paul Morigi/flickr/CC

A little-noticed scheme hatched in the late stages of the Trump presidency has consumer advocates and universal healthcare proponents warning about a creeping attempt to further privatize Medicare—an effort the Biden administration is being urged to stop in its tracks.

On December 3, the Centers for Medicare and Medicaid Services (CMS)—then under the leadership of Seema Verma—unveiled an innocuous-sounding proposal titled the Geographic Direct Contracting Model (Geo) with the purported goal of delivering “Medicare beneficiaries value through better care and improved quality.” Continue reading

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