For many years, the Center for Medicare Advocacy has advocated for legislative and administrative efforts to address the growing inequities between Medicare Advantage (MA) and traditional Medicare, that favor MA, and encourage the growing … [Read more...] about Call to Action – Policy Makers Must Increase Medicare Advantage Oversight and Rein in Overpayments
Medicare Advantage
Medicare Advantage is Not the Solution to Medicare Equity or Solvency Problems
By Marilyn Moon, Ph.D. - Center for Medicare Advocacy Visiting Scholar, Medicare Analyst, Former Public Trustee of Medicare and Social Security Sadly, one of the myths about Medicare Advantage (MA) is that it is better for minorities and persons … [Read more...] about Medicare Advantage is Not the Solution to Medicare Equity or Solvency Problems
Office of Inspector General (OIG) Issues Another Report Highlighting Inappropriate Medicare Advantage Denials
Prior Authorization as a Barrier to Care Prior authorization and other utilization management tools can serve as significant barriers to care that both current and prospective Medicare Advantage enrollees are often unaware of until they need to … [Read more...] about Office of Inspector General (OIG) Issues Another Report Highlighting Inappropriate Medicare Advantage Denials
Insurance Industry v. Provider Response to OIG Report re: MA Denials
The recently issued HHS Office of Inspector General report focusing on Medicare Advantage plan denials titled “Some Medicare Advantage Organization Denials of Prior Authorization Requests Raise Concerns About Beneficiary Access to Medically Necessary … [Read more...] about Insurance Industry v. Provider Response to OIG Report re: MA Denials
OIG Report Estimates of Inappropriate MA Plan Denials May be Understated
The recently issued HHS Office of Inspector General (OIG) report focusing on Medicare Advantage plan denials titled “Some Medicare Advantage Organization Denials of Prior Authorization Requests Raise Concerns About Beneficiary Access to Medically … [Read more...] about OIG Report Estimates of Inappropriate MA Plan Denials May be Understated
(Most) Policymakers Fail to Act on Medicare Advantage Oversight and Overpayment
For many years, the Center for Medicare Advocacy has advocated for legislative and administrative efforts to address the growing inequities between Medicare Advantage (MA) and traditional Medicare that favor MA, and thus encourage the growing … [Read more...] about (Most) Policymakers Fail to Act on Medicare Advantage Oversight and Overpayment
Government Watchdog Issues Another Report Highlighting Inappropriate Medicare Advantage Denials
The Department of Health and Human Services Office of Inspector General (OIG) issued a report titled “Some Medicare Advantage Organization Denials of Prior Authorization Requests Raise Concerns About Beneficiary Access to Medically Necessary Care” … [Read more...] about Government Watchdog Issues Another Report Highlighting Inappropriate Medicare Advantage Denials
When Artificial Intelligence in Medicare Advantage Impedes Access to Care: A Case Study
The use of artificial intelligence (AI) in healthcare is capturing headlines as a potential tool to streamline operations and predict patient needs for favorable health outcomes, among other things.[1] The Center for Medicare Advocacy, however, has … [Read more...] about When Artificial Intelligence in Medicare Advantage Impedes Access to Care: A Case Study
Members of Congress Send Letter to CMS Urging Agency to Address Medicare Advantage Overpayments
On April 20, 2022, 19 members of the House and Senate sent a letter to Centers for Medicare & Medicaid (CMS) Administrator Chiquita Brooks-LaSure “highlighting concerns about overpayments to Medicare Advantage plans that line the pockets of big … [Read more...] about Members of Congress Send Letter to CMS Urging Agency to Address Medicare Advantage Overpayments
Commonwealth Fund Blog Series About Medicare Advantage
Over the last several weeks, the Commonwealth Fund, a private foundation with a mission “to promote a high-performing health care system that achieves better access, improved quality, and greater efficiency, particularly for society’s most … [Read more...] about Commonwealth Fund Blog Series About Medicare Advantage