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Many Medicare Advantage plans send caregivers to the homes of seniors periodically to help with housework and provide companionship. But the workers may also prod seniors into activities that boost the plans’ Medicare ratings and federal reimbursements.
Private and public employers are increasingly using the government’s Medicare Advantage program as an alternative to their existing retiree health plan and traditional Medicare coverage. As a result, the federal government is paying the “overwhelming majority” of medical costs, according to an industry analyst.
Medicare officials say complaints are rising from seniors lured into private plans with misleading information or enrolled without their consent. In response, officials have threatened to penalize the private companies selling Medicare Advantage and drug plans if they or agents working on their behalf mislead consumers.
Some insurers pocketed ‘eye-popping’ overpayments, billing records show.
As lawmakers weigh new spending provisions to cover dental, hearing and vision services for Medicare beneficiaries, a group supporting Medicare Advantage plans is airing commercials that raise concerns about the funding for those private plans.
The feds’ civil suit links exaggerated patient bills to “tens of millions” in overcharges.
As the delta variant continues to spread around the U.S., the Biden administration is taking steps to authorize covid vaccine boosters, require nursing home workers to be vaccinated and protect school officials who want to require masks despite state laws banning those mandates. Meanwhile, the U.S. House is returning from its summer break early to start work on its giant budget bill, which includes a long list of health policy changes. Alice Miranda Ollstein of Politico, Margot Sanger-Katz of The New York Times and Kimberly Leonard of Business Insider join KHN’s Julie Rovner to discuss these issues and more.
When the program began half a century ago, backers believed the benefits would expand over time, but politics and concerns about money have stymied most efforts. Now congressional Democrats are looking to add vision, dental and hearing care.
Insurers voluntarily set the charges aside earlier in the pandemic — but that means those same health plans can decide to reinstate them.
Medicare Advantage company may face record penalty over alleged billing errors.
Government officials want to focus on fighting COVID-19 instead of recouping overcharges that run into the millions.
One woman's experience with the high cost of dental care and confusing Medicare coverage offers a teachable moment for other consumers. Her small church took up a collection, but the surprise bill — four times what she expected to pay — was sent to collections.
A lawsuit against Group Health surfaces as the White House promotes Medicare Advantage for seniors.
For more than a decade, customers used the online plan finder to compare dozens of policies. Yet after a redesign of the website, the search results no longer list which plan offers a customer the best value. Federal officials say it will be fixed before enrollment begins next week.
The president’s outline of key health policy concerns touched on a variety of hot-button issues from drug prices to immigration.
President Donald Trump, dogged by an impeachment inquiry, tries to change the subject by unveiling an executive order aimed at expanding the role of private Medicare health plans. The Trump administration also launched an effort this week to expand “wellness” programs aimed at getting people with insurance to practice better health habits – even though research has shown the efforts don’t generally improve health or save money. This week, Alice Miranda Ollstein of Politico, Kimberly Leonard of the Washington Examiner and Rebecca Adams of CQ Roll Call join KHN’s Julie Rovner to discuss these issues and more.
The Freedom of Information Act lawsuit could spur the Centers for Medicare & Medicaid Services to release audits that document up to $650 million in overcharges.
Amid an overall crackdown on private insurers’ Medicare billing practices, a new government audit and a whistleblower suit allege St. Louis-based Essence Group Holdings Corp.'s Medicare Advantage plans overcharged taxpayers.
An enhanced government effort to catch insurers that overcharge Medicare faces resistance from the insurance industry.
The problem affects private drug policies and Medicare Advantage plans that provide both medical and drug coverage and substitute for traditional government-run Medicare. It could leave plan members without coverage.
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