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
Medicare Advantage
(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
A Special Alert about Medicare’s Future | Don’t Let Traditional Medicare “Wither on the Vine*”
Recent CMA Alerts (for example, here) have discussed how policymakers fail to address the growing inequities between Medicare Advantage (MA) and traditional Medicare that favor MA, and encourage the growing privatization of the Medicare program. … [Read more...] about A Special Alert about Medicare’s Future | Don’t Let Traditional Medicare “Wither on the Vine*”
Medicare Advantage Plans Pitch to People Turning 65
In “How Do Insurers Love Thee? Let Us Count the Medicare Advantage Pitch Mailings,” Barron’s reporter Neal Templin describes, as he turned 65, being “bombarded with letters for months” from Medicare Advantage (MA) Plans soliciting his business. … [Read more...] about Medicare Advantage Plans Pitch to People Turning 65
Recent Solicitation Scams Target Medicare-Eligible Adults
A recent report in The Roanoke Times highlighted a growing vulnerability in the Medicare system – suspicious phone solicitations targeting potential beneficiaries as they prepare to sign up for Medicare.[1] These calls specifically target … [Read more...] about Recent Solicitation Scams Target Medicare-Eligible Adults
CMS Needs to Rein in Medicare Advantage Overpayments and Heighten Oversight of Insurance Industry
Center Comments Regarding CMS’ Advance Payment Notice and Proposed Part C & D Rule The Center for Medicare Advocacy recently submitted comments to the Centers for Medicare & Medicaid Services (CMS) regarding their Advance payment rule … [Read more...] about CMS Needs to Rein in Medicare Advantage Overpayments and Heighten Oversight of Insurance Industry