Investigation On Medicare Advantage Plans Finds Widespread, Persistent Problems Related To Denials Of Care
The investigation by the HHS inspector general raises some concerns just as Medicare Advantage plans become more and more popular. Analysts predict that one in two seniors will have them in a few years despite predictions that the health law would hobble the marketplace.
The New York Times:
Medicare Advantage Plans Found To Improperly Deny Many Claims
Medicare Advantage plans, the popular private-insurance alternative to the traditional Medicare program, have been improperly denying many medical claims to patients and physicians alike, federal investigators say in a new report. The private plans, which now cover more than 20 million people — more than one-third of all Medicare beneficiaries — have an incentive to deny claims “in an attempt to increase their profits,” the report says. (Pear, 10/13)
Kaiser Health News:
Medicare Advantage Riding High As New Insurers Flock To Sell To Seniors
Health care experts widely expected the Affordable Care Act to hobble Medicare Advantage, the government-funded private health plans that millions of seniors have chosen as an alternative to original Medicare. To pay for expanding coverage to the uninsured, the 2010 law cut billions of dollars in federal payments to the plans. Government budget analysts predicted that would lead to a sharp drop in enrollment as insurers reduced benefits, exited states or left the business altogether. (Galewitz, 10/15)
The Star Tribune:
Insurers Target Seniors With Shifting Medicare Options
With a marketing blitz for products old and new, health insurers are pulling out all the stops in Minnesota to woo more than a quarter-million Medicare beneficiaries who must find new coverage for 2019. Open enrollment for people in Medicare starts Monday, and a Star Tribune analysis of federal data shows that consumers are seeing big changes in the lineup of Medicare health plan offerings, including more of an urban-rural divide in the choices they’re finding. (Snowbeck and Webster, 10/14)
In other Medicare news —
CQ:
Doctors And Patients Take Sides On Medicare Heart Valve Funding
Lawmakers and patient groups are at odds with many physicians over whether Medicare should liberalize its coverage criteria for a $50,000 heart-valve replacement procedure, a decision with big stakes for the device-makers and providers involved. The patient groups and lawmakers, with support from one heart valve-maker, want more patients to have access to the procedure. Several physicians' groups — along with two other companies that also make the heart valve — argue there is no evidence to support certain changes and suggest they could put some patients at risk of harm. (Siddons, 10/15)
