Records show Medicare Advantage plans overbill taxpayers by billions annually

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    • #328833
      Cold Mountain Trail
      • Total Posts: 8,752

      Health insurers that treat millions of seniors have overcharged Medicare by nearly $30 billion over the past three years alone, but federal officials say they are moving ahead with long-delayed plans to recoup at least part of the money…

      Getting refunds from the health plans has proved daunting, however. Officials with the Centers for Medicare & Medicaid Services repeatedly have postponed or backed off efforts to crack down on billing abuses and mistakes by the increasingly popular Medicare Advantage health plans offered by private health insurers under contract with Medicare. Today, such plans treat more than 22 million seniors — more than 1 in 3 people on Medicare.

      Now CMS is trying again…As in past years, such scrutiny faces an onslaught of criticism from the insurance industry…  But former Sen. Claire McCaskill, a Missouri Democrat who now works as a political analyst, says officials must move past powerful lobbying efforts. The officials must hold health insurers accountable, McCaskill says, and demand refunds for “inappropriate” billings…

    • #328836
      • Total Posts: 1,831

      The Insurance Industry thinks they are health care, more to the point, they also present themselves that way.

      So there is the problem, insurance is not health care and have no business telling me or my doctor what to do.

      All of that B.S. about keeping government out of my healthcare, keep psychopathic corporations out of my healthcare. That would fit on a bumper sticker.

      If you cannot dazzle them with brilliance, baffle them with bullshit WC Fields

      • #328838
        retired liberal
        • Total Posts: 2,689

        Parasites, everyone of them. Single Payer, Universal Health Care. It works just fine in the rest of the world, just not here for some reason. Can you say GREED? Sure you can.

        We are an arrogant species, believing our fantasy based "facts" are better than the other person's fake facts.
        If you are wrong, it will be because you are not cynical enough.
        Both major political parties are special interest groups enabling each other for power and money, at the expense of the people they no longer properly serve…
        Always wear a proper mask when out and about. The life you save could be both yours and mine.

    • #328840
      • Total Posts: 3,475

      They saturation advertise on the TV channels that run old movies and retro television series such as Andy Griffith, Ed Sullivan, etc. When I watch these channels, all I see are ads for Medicare Advantage plans and reverse mortgages, another ripoff for old people. They make vague promises about “$243 a month back from Medicare” and “coverage for eyeglasses, prescription drugs and more.” Old people appear on the screen and offer testimonials about how one card takes care of everything and the “zero dollar premium” saves them money. Of course, only a handful of people, those who are Medicaid eligible, qualify for the full list of benefits at no cost. The companies make their money by getting old people to call and then up-selling them with various sorts of coverage. These shysters are another reason I would love to see M4A, which would put them out of business overnight.

    • #328850
      • Total Posts: 1,193

      A few years ago I retired. A person at the clinic where I was going for health care told me that I qualified for MediCal because all they asked for was income ($0) not assets (which were about $500,000 I’d paid off my mortgage) Soon as He found out I was on MediCal my doctor sent me to specialists. Then I went on Medicare, and the qualification changed. No more MediCal.

      One of my specialists was a hematologist. (I have a b12 deficiency) Every 3 months she called me in, looked at a number on a blood test, and told me to either keep taking otc b12  or go in for injections. Then the bills started. (the specialists are outpatient) I told the hematologist she was “by far the most expensive of my specialists” and she answered, “Doesn’t your insurance pay for it?” I answered, “Only part. This call (it was a phone consultation because of the virus) is costing me $21o.” She said,”I’ll send you back to your primary and tell her what to look for.”

      This is a doctor at a public clinic. She, and the clinic, is not price gouging anyone. But because almost all of us patients are on MediCal she has no idea how much she costs. Almost no doctors know how much they cost. Few patients know how much doctors cost. (but there are more of us every day) That’s the true evil of insurance; they keep anyone from knowing how much things cost, so people can charge whatever they want. Like credit cards – people who pay with credit cards spend over a third more than people who pay in cash, according to the credit card companies. That’s why governments are trying to go cashless. (that and credit card balances are on the bank’s books as liabilities rather than assets, so the bank doesn’t have to insure them until they are paid – a nice scam to remember next time your bank asks for a bailout)

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