The Medicare Advantage Influence Machine
By Fred Schulte Holly K. Hacker
September 30, 2024
KFF Health News Original
New court filings and lobbying reports reveal an industry drive to tamp down critics — and retain billions of dollars in overcharges.
Some Rural Hospitals Ditch Medicare Advantage
By Arielle Zionts
April 11, 2025
KFF Health News Original
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Federal Watchdog Urges Crackdown on Medicare Advantage Home Visits
By Fred Schulte
November 22, 2024
KFF Health News Original
Medicare officials are pushing back against a federal watchdog’s call to crack down on home visits by Medicare Advantage health plans — a practice the watchdog says may waste billions of tax dollars every year. In late October, a Health and Human Services inspector general audit found that the insurers pocketed $7.5 billion in 2023 from diagnosing health conditions that […]
Watchdog Calls for Tighter Scrutiny of Medicare Advantage Home Visits
By Fred Schulte
November 8, 2024
KFF Health News Original
Medicare officials defend the use of home visits that often spot medical conditions that are never treated.
Rural Hospitals Question Whether They Can Afford Medicare Advantage Contracts
By Arielle Zionts
April 8, 2025
KFF Health News Original
Some rural hospitals have canceled — or are considering ending — contracts with insurance companies that offer Medicare Advantage plans, saying the private policies jeopardize their finances and impede patient care.
When Hospitals Ditch Medicare Advantage Plans, Thousands of Members Get To Leave, Too
By Susan Jaffe
April 28, 2025
KFF Health News Original
Breakups between health providers and Advantage plans are increasingly common. The Centers for Medicare & Medicaid Services has allowed whole groups of patients to leave their plans.
KFF Health News Sues To Force Disclosure of Medicare Advantage Audit Records
By Fred Schulte
November 12, 2024
KFF Health News Original
Freedom of Information Act case targets HHS inspector general’s reviews of billions of dollars in health plan overpayments.
UnitedHealth Wins Ruling Over $2B in Alleged Medicare Advantage Overpayments
By Fred Schulte
March 4, 2025
KFF Health News Original
A special master found the Justice Department failed to prove wrongdoing by the giant health insurer.
Feds Killed Plan To Curb Medicare Advantage Overbilling After Industry Opposition
By Fred Schulte
August 27, 2024
KFF Health News Original
A private 2014 decision by the Centers for Medicare & Medicaid Services faces new scrutiny in a multibillion-dollar Justice Department fraud case against UnitedHealth Group.
Hospitals and Doctors Are Fed up With Medicare Advantage
By Julie Appleby
November 29, 2023
KFF Health News Original
Medicare Advantage plans are pretty popular with both lawmakers and ordinary Americans — they now enroll about 31 million people, representing just over half of everyone in Medicare, by KFF’s count. But among doctors and hospitals, it’s a different story. Across the country, provider grumbling about claim denials and onerous preapproval requirements by Advantage plans […]
Election Outcome Could Bring Big Changes to Medicare
By Stephanie Armour
Updated November 4, 2024
Originally Published November 4, 2024
KFF Health News Original
Democrats and conservatives are divided over whether the federal health program for people over 65 should be run almost entirely by the private sector. If Trump retakes the White House, the shift to Medicare Advantage may accelerate.
Medicare Advantage Increasingly Popular With Seniors — But Not Hospitals and Doctors
By Julie Appleby
November 29, 2023
KFF Health News Original
Some hospitals and physician groups are rejecting Medicare Advantage plans over payment rates and coverage restrictions, causing turmoil for patients.
Older Americans Say They Feel Trapped in Medicare Advantage Plans
By Sarah Jane Tribble
January 5, 2024
KFF Health News Original
As enrollment in private Medicare Advantage plans grows, so do concerns about how well the insurance works, including from those who say they have become trapped in the private plans as their health declines.
In Settling Fraud Case, New York Medicare Advantage Insurer, CEO Will Pay up to $100M
By Fred Schulte
December 20, 2024
KFF Health News Original
A whistleblower suit alleged a health insurer bilked Medicare by exaggerating how sick patients were.
Medicare Advantage Is Popular, but Some Beneficiaries Feel Buyer’s Remorse
By Sarah Jane Tribble
January 23, 2024
KFF Health News Original
Medicare Advantage plans are booming — 30.8 million of the 60 million Americans with Medicare are now enrolled in the private plans rather than the traditional government-run program. But a little-known fact: Once you’re in a Medicare Advantage plan, you may not be able to get out. Traditional Medicare usually requires beneficiaries to pay 20 […]
Watch: Older Americans Say They Feel Stuck in Medicare Advantage Plans
By Sarah Jane Tribble
January 22, 2024
KFF Health News Original
You’ve probably seen advertising about Medicare Advantage plans. KFF Health News’ Sarah Jane Tribble explains the pros and cons of this insurance option as enrollment in these plans increases.
Readers Weigh Downsides of Medicare Advantage and Stick Up for Mary Lou Retton
January 29, 2024
KFF Health News Original
KFF Health News gives readers a chance to comment on a recent batch of stories.
Uncle Sam Wants You … to Help Stop Insurers’ Bogus Medicare Advantage Sales Tactics
By Susan Jaffe
November 30, 2023
KFF Health News Original
The Biden administration wants to crack down on deceptive or misleading Medicare Advantage and drug plan sales tactics. It’s counting on beneficiaries to help catch offenders.
Adultos mayores, detectives contra avisos engañosos de Medicare Advantage
By Susan Jaffe
November 30, 2023
KFF Health News Original
Funcionarios de los Centros de Servicios de Medicare y Medicaid le han pedido a las personas mayores y a otros miembros de la comunidad que sean detectives contra el fraude, denunciando tácticas de venta engañosas al 800-MEDICARE.
Adultos mayores se sienten “atrapados” en planes de Medicare Advantage
By Sarah Jane Tribble
January 5, 2024
KFF Health News Original
Al parecer el programa de planes privados para adultos mayores comienza a presentar obstáculos cuando surgen enfermedades.
