Medicare Advantage

Medicine

Feds killed plan to curb Medicare Advantage overbilling after industry opposition

Federal officials backed off plan to curb Medicare Advantage overcharges due to industry pressure, leading to ongoing fraud allegations against insurers. [ more ]

Truthout

Medicine

After Industry Uproar, Feds Killed Plan to Curb Medicare Advantage Overbilling

CMS initially sought to regulate Medicare Advantage overcharging but withdrew efforts due to industry pressure, leaving serious implications for Medicare integrity. [ more ]

www.npr.org

2 months ago

Public health

California tries but fails to fix a major Medicare loophole for seniors

Seniors face a crucial decision when choosing between traditional Medicare and Medicare Advantage plans, where the trade-off lies between predictability and flexibility in healthcare coverage. [ more ]

Axios

Public health

Why health insurers suddenly want sicker patients

Insurers are expected to generate billions in profit from the dual eligible population, despite their expensive health care needs.

Insurance plans' government segment is projected to be 65% more profitable than the commercial segment by 2027. [ more ]

www.bostonherald.com

Public health

What to do if your hospital drops your Medicare Advantage plan

More than half of Medicare-eligible people are enrolled in Medicare Advantage, but hospitals have been dropping these plans due to issues with prior authorizations and denials.

Hospitals and health systems in at least 11 states announced they would be out-of-network for some or all Medicare Advantage plans in 2024. [ more ]

Fortune

8 hours ago

Public health

Medicare Advantage shopping tips: Avoid this enrollment mistake

Start considering Medicare coverage options before the enrollment window opens to avoid last-minute decisions. [ more ]

Cbsnews

Medicine

Feds killed plan to curb Medicare Advantage overbilling after industry opposition

Federal officials backed off plan to curb Medicare Advantage overcharges due to industry pressure, leading to ongoing fraud allegations against insurers. [ more ]

Truthout

Medicine

After Industry Uproar, Feds Killed Plan to Curb Medicare Advantage Overbilling

CMS initially sought to regulate Medicare Advantage overcharging but withdrew efforts due to industry pressure, leaving serious implications for Medicare integrity. [ more ]

www.npr.org

2 months ago

Public health

California tries but fails to fix a major Medicare loophole for seniors

Axios

Public health

Why health insurers suddenly want sicker patients

Insurers are expected to generate billions in profit from the dual eligible population, despite their expensive health care needs.

Insurance plans' government segment is projected to be 65% more profitable than the commercial segment by 2027. [ more ]

www.bostonherald.com

Public health

What to do if your hospital drops your Medicare Advantage plan

More than half of Medicare-eligible people are enrolled in Medicare Advantage, but hospitals have been dropping these plans due to issues with prior authorizations and denials.

Hospitals and health systems in at least 11 states announced they would be out-of-network for some or all Medicare Advantage plans in 2024. [ more ]

moremedicare-advantage

www.npr.org

Public health

Uncle Sam wants you to help stop insurers' bogus Medicare Advantage sales tactics

The Biden administration is encouraging the public to report misleading or deceptive sales tactics by insurers selling private Medicare Advantage and drug plans.

Specific sales pitches to watch out for include claims that suggest benefits are available to all when only some individuals qualify, mentioning benefits that are not available in the advertised service area, and using superlatives without data to back them up.

The public is also warned to be wary of companies pretending to be from the government-run Medicare program and should report any violations to CMS at 800-MEDICARE. [ more ]

#Cigna

WSJ

Business intelligence

Cigna-Humana Merger Is Likely to Face Antitrust Challenge

Cigna and Humana's merger could create a powerful healthcare company.

The merger would allow Cigna to enter the highly lucrative Medicare Advantage industry.

The combined company would compete with UnitedHealth Group, the current industry leader in Medicare Advantage. [ more ]

WSJ

Business intelligence

Cigna-Humana Merger Is Likely to Face Antitrust Challenge

Cigna and Humana could merge to create a healthcare powerhouse

Cigna has a large pharmacy benefit management business while Humana has a strong presence in the Medicare Advantage industry [ more ]

WSJ

Business intelligence

Cigna-Humana Merger Is Likely to Face Antitrust Challenge

Cigna and Humana's merger could create a powerful healthcare company.

The merger would allow Cigna to enter the highly lucrative Medicare Advantage industry.

The combined company would compete with UnitedHealth Group, the current industry leader in Medicare Advantage. [ more ]

WSJ