Tag Archives: Medicare Part B

‘This Should Be a National Scandal’: For-Profit Medicare Advantage Plans Using AI for Denials

“They’re using AI to predict when to cut off payment for treatments,” said one watchdog group. “We repeat, AI. Not a doctor.”

By Brett Wilkins. Published 11-3-2023 by Common Dreams

*Single payer protest in Baltimore, MD Photo: Elvert Barnes/flickr/CC*

As Medicare Advantage plans rely increasingly upon artificial intelligence to determine—and often deny—payment for patient care, a group of Democratic U.S. lawmakers on Friday urged Medicare’s top official to strengthen oversight of AI and algorithmic tools used to make coverage determinations.

“In recent years, problems posed by prior authorization have been exacerbated by MA plans’ increasing use of AI or algorithmic software to assist in their coverage determinations in certain care settings, including inpatient hospitals, skilled nursing facilities, and home health,” 32 House Democrats led by Rep. Judy Chu (D-Calif.) wrote in a letter to Centers for Medicare & Medicaid Services (CMS) Administrator Chiquita Books LaSure.

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‘Good News for Seniors’: Becerra Orders Medicare to Reassess Premium Hike

“It is unconscionable,” said one advocate welcoming the announcement, “for Medicare premiums to increase this dramatically because of one corporation’s greed.”

By Brett Wilkins. Pubished 1-10-2022 by Common Dreams

U.S. Health and Human Services Secretary Xavier Becerra announced on January 10, 2022 that he was ordering a review of a planned 15% hike in the Medicare Part B premium. Photo: Gage Skidmore/flickr/CC

As the head of the U.S. Department of Health and Human Services announced Monday that he was ordering a review of a planned 15% hike in the Medicare Part B premium for 2022, healthcare reform advocates stressed the need for Congress to pass a Build Back Better bill with a provision allowing the federal government to negotiate the price of prescription drugs.

HHS Secretary Xavier Becerra said that he was instructing the Centers for Medicare and Medicaid Services (CMS) “to reassess the recommendation for the 2022 Medicare Part B premium”—a hike that progressive critics said was largely the result of the pharmaceutical industry’s outrageous profiteering. Continue reading →

‘Reckless’ FDA and Big Pharma Greed Blamed for Medicare Premium Hike

“All Part B Medicare beneficiaries soon will be forced to bear significant financial burden as a direct result of the FDA’s reckless decision.”

By Jake Johnson. Published 11-16-2021 by Common Dreams

Janet Woodcock, acting commissioner of the Food and Drug Administration. Screenshot: FDA

Medicare Part B recipients will soon be hit with one of the biggest premium increases in the history of the government program, a hike driven in large part by the Food and Drug Administration’s scandalous approval of a costly—and, according to many experts, dubious—Alzheimer’s drug.

Last week, the Centers for Medicare and Medicaid Services (CMS) announced that monthly Medicare Part B premiums will be raised to $170.10 in 2022, up from this year’s level of $148.50. Continue reading →

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Tag Archives: Medicare Part B