A Message from the Executive Director
The New York Times recently published an article by Reed Abelson and Magot Sanger-Katz discussing the frenzied reaction of private Medicare Advantage plans to the Administration’s proposed changes to payment. Biden Plan to Cut Billions in Medicare Fraud Ignites Lobbying Frenzy focuses on the “buckets of money,” as Arnold Ventures executive vice president of health care Mark Miller calls them, that the industry is pouring into any changes that would affect their overpayments. “Without reforms,” say Reed and Sanger-Katz, ”taxpayers will spend about $25 billion next year in “excess” payments to the private plans.”
It’s high time that this over-reach of private Medicare Advantage plans is called what it is: Fraud. Medicare Advantage overpayments threaten Medicare’s fiscal sustainability. At the same time, these private plans block access to necessary care with baseless prior authorization and on-going Medicare denials. In short, Medicare Advantage costs the Medicare program and taxpayers more, but provides beneficiaries less when they really need care. It’s refreshing to see the Administration and numerous legislators putting the public good, the Medicare program, and beneficiaries first – and demanding real value from Medicare Advantage insurers.
Center for Medicare Advocacy