Tag: Medicare Advantage

Fight to Rename ‘Medicare Advantage’ Gets New Push

Mary Pat Campbell

Link: https://www.thinkadvisor.com/2023/02/01/fight-to-rename-medicare-advantage-gets-new-push/

Excerpt:

Rep. Mark Pocan and two colleagues are reviving a fight to take “Medicare” out of the name of the Medicare Advantage program — and, this time, they have a YouTube that looks like a parody of a Medicare Advantage TV ad.

The Wisconsin Democrat introduced the new version of the Save Medicare Act bill today, together with Reps. Ro Khanna, D-Calif., and Jan Schakowsky, D-Il..

The sponsors are promoting the position that “only Medicare is Medicare,” and that a Medicare Advantage plan may fail to provide the care that an older Medicare enrollee might need.

….

The bill would rename the Medicare Advantage program and prohibit Medicare Advantage plans from using the word “Medicare” in plan titles or ads.

The Pocan-Khanna-Schakowsky bill is a new version of H.R. 9187, a bill that Pocan and Khanna introduced in the 117th Congress. That bill had a total of four co-sponsors, all Democrats.

H.R. 9187 died in the House Energy and Commerce Committee and the House Ways and Means Committee at a time when Democrats controlled the House.

Author(s): Allison Bell

Publication Date: 1 Feb 2023

Publication Site: Think Advisor

How Medicare Advantage Plans Dodged Auditors and Overcharged Taxpayers by Millions

Mary Pat Campbell

Link: https://khn.org/news/article/medicare-advantage-auditors-overcharged-taxpayers/

Excerpt:

A review of 90 government audits, released exclusively to KHN in response to a Freedom of Information Act lawsuit, reveals that health insurers that issue Medicare Advantage plans have repeatedly tried to sidestep regulations requiring them to document medical conditions the government paid them to treat.

The audits, the most recent ones the agency has completed, sought to validate payments to Medicare Advantage health plans for 2011 through 2013.

As KHN reported late last month, auditors uncovered millions of dollars in improper payments — citing overcharges of more than $1,000 per patient a year on average — by nearly two dozen health plans.

Author(s): Fred Schulte and Holly K. Hacker

Publication Date: 13 Dec 2022

Publication Site: Kaiser Health News

The New York City Unions Whose Backdoor Deal Sold Out Retirees, Helped Insurance Industry

Mary Pat Campbell

Link: https://www.newsweek.com/new-york-city-unions-whose-backdoor-deal-sold-out-retirees-helped-insurance-industry-1604661

Excerpt:

In recent years, leadership of some of the nation’s largest unions have publicly opposed single-payer health care proposals, angering their rank-and-file and forcing Democratic politicians who back single-payer to take on a key constituency.

In New York City, for example, the umbrella organization for the city’s public sector unions—the Municipal Labor Committee (MLC)—recently helped the health insurance industry block a statewide single-payer bill, on the grounds that their members wanted to keep the health care benefits for which they had sacrificed wage increases.

But it turns out that the MLC, which bargains for health care benefits for city unions, was also engaging in backdoor negotiations with the city, resulting in a proposal to switch nearly a quarter-million people from Medicare to privately administered Medicare Advantage plans.

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Following the 2018 cost-cutting agreement, union leaders and officials came up with eight proposals to meet the cost-cutting requirements, including switching to a statewide single-payer system or setting up a self-insurance system.

A January 2021 study by The New School found that the city could save about $1.6 billion per year if it adopted a self-insurance program, as most major cities and large companies have done. That would involve setting up a health insurance plan just for the city’s employees and paying for claims directly, rather than paying premiums to a health insurance company which tends to be more expensive because insurance company profit margins are so large.

But since the negotiations between the MLC and Office of Labor Relations were held behind closed doors, retirees don’t know whether this option was ever considered.

Author(s): JULIA ROCK, THE DAILY POSTER

Publication Date: 28 June 2021

Publication Site: Newsweek