Feds Will Redo This Year’s Medicare Advantage Quality Ratings
The decision, announced late Thursday, comes in the wake of two court rulings that faulted the agency’s ratings, The Wall Street Journal reported. Also: Legionella bacteria are detected at CMS headquarters near Baltimore.
The Wall Street Journal:
Medicare Will Recalculate Quality Ratings Of Medicare Advantage Plans
The federal government plans to redo this year’s quality ratings of private Medicare plans, a move that will deliver hundreds of millions in additional bonus payments to insurers next year. The decision by the Centers for Medicare and Medicaid Services was announced late Thursday, after The Wall Street Journal reported the agency’s plans. It comes in the wake of two court rulings that faulted the agency’s ratings, in cases filed by insurers SCAN Health Plan and Elevance Health. (Mathews, 6/13)
Nation of Change:
The Medicare Advantage Paradox: How Private Insurers Cost Taxpayers Billions
Medicare Advantage (MA) has recently reached a milestone with enrollment surpassing 30 million. The health insurance industry’s trade group claims MA is beneficial for both members and taxpayers. However, recent studies and reports from the Medicare Payment Advisory Commission (MedPAC) reveal that MA overpayments have significantly burdened taxpayers. MedPAC estimated that MA over payments added $82 billion to taxpayer costs in 2023 and $612 billion between 2007 and 2024. These over payments are driven by two main strategies: Diagnosis up-coding and avoiding enrollees who require costly care. (Jacobo, 6/13)
CMS headquarters is temporarily closed —
The Washington Post:
Medicare Shutters Headquarters After Legionella Bacteria Detected
The Baltimore-area headquarters of the Centers for Medicare and Medicaid Services is closed after bacteria linked to a serious pneumonia called Legionnaire’s disease was discovered in the water supply. Officials described the move as precautionary and said they were not aware of any staff members suffering health issues related to the bacteria. The General Services Administration found the Legionella bacteria when testing new plumbing fixtures before reopening construction sites at CMS headquarters, which has been undergoing renovations. The building was shuttered Friday. (Diamond, 6/13)
