Inspector General, AMA and AHA Agree: Some Medicare Advantage Plans Are Endangering Their Enrollees’ Lives

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    • #490154
      • Total Posts: 11,935

      This is not the first time that the OIG has raised serious concerns about Medicare Advantage. But Medicare Advantage plans continue to engage in widespread wrongful denials of care with little accountability. What will it take for the administration and Congress to protect people with Medicare from these bad actors?

      In a 2018 report, the OIG raised equally troubling concerns about the risks faced by older adults and people with disabilities in Medicare Advantage. The OIG recommended that the Centers for Medicare and Medicaid Services (CMS) act to protect people with Medicare and provide them “with clear, easily accessible information about serious [Medicare Advantage] violations.” Unfortunately, these recommendations seem to have fallen on deaf ears. Instead of calling out the bad Medicare Advantage actors and holding them to account, CMS is protecting corporate interests over the interests of older adults, people with disabilities, and their families. Protecting Wall Street over people with Medicare.

      The OIG report explains that because CMS pays Medicare Advantage plans a flat fee regardless of the amount they spend on care, they have a “potential incentive…to deny beneficiary access to services and deny payments to providers in an attempt to increase profits.”

      Anyone enrolled in a Medicare Advantage plan offered by Humana, United HeathCare, Aetna, or another health insurance company should beware. These Medicare Advantage plans are requiring that our nation’s most vulnerable individuals navigate an obstacle course when they need critical care. Worse still, they are inappropriately denying potentially life-saving care to tens of thousands of older adults and people with disabilities —care that traditional Medicare covers.

      Jesus: Hey, Dad? God: Yes, Son? Jesus: Western civilization followed me home. Can I keep it? God: Certainly not! And put it down this minute--you don't know where it's been! Tom Robbins in Another Roadside Attraction

    • #490179
      • Total Posts: 8,711

      I am told – you are 75/76, just take an Advil for a pretty bad knee bone on bone situation, and this year I am told that at 76, there is no point in any of that battery of once lucrative tests being wasted on me – but if I notice anything amiss, I should make an appointment.  This is BOTH fucking parties signing off on this.

      America is not a country, it's just a business. (Brad Pitt, Killing Them Softly)

      "Sometimes when I try to understand a person's motives, I play a little game. I assume the worst. What's the worst reason they could possibly have for saying what they say and doing what they do? Then I ask myself, 'How well does that reason explain what they say and what they do?'" GRRM

      A YouTube comment – we need new conspiracy theories – the old ones have all come true.

    • #490332
      • Total Posts: 1,968
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