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News Articles: Medicare Advantage

People gathered at the U.S. Capitol in Washington, D.C. in July at a rally held by the Center for Medicare Advocacy. They protested denials and delays in private Medicare Advantage plans.

Uncle Sam wants you to help stop insurers' bogus Medicare Advantage sales tactics

The Biden administration is cracking down on deceptive or misleading Medicare Advantage and drug plan sales tactics. And it's counting on beneficiaries to help catch offenders.

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By:
  • Susan Jaffe
Since 2010, 150 rural hospitals have closed in the United States. Hospital leaders say that Medicare Advantage pays slowly and sometimes not at all and that this could push more hospitals to the brink.

Medicare Advantage keeps growing. Tiny, rural hospitals say that's a huge problem

More than half of seniors choose private Medicare Advantage plans instead of traditional Medicare. As rural enrollment increases, many small-town hospitals say that threatens their viability.

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By:
  • Sarah Jane Tribble
Open enrollment for Medicare begins Sunday and ads like this billboard inside California's John Wayne Airport are popping up. Marketing of Medicare plans is subject to new, stricter federal regulations this year.

Medicare shoppers often face a barrage of unsolicited calls and aggressive ads

Medicare's annual open enrollment period began Oct. 15, allowing seniors to choose new plans. New rules this year are supposed to crack down on misleading marketing but buyers should still beware.

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By:
  • Leslie Walker and
  • Dan Gorenstein

How Medicare Advantage plans dodged auditors and overcharged taxpayers by millions

A KHN investigation found when some Medicare Advantage plans got a rare federal audit, they couldn't produce billing records for care they said they'd provided. Some blamed fire, flood — or doctors.

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By:
  • Fred Schulte and
  • Holly K. Hacker

Hidden audits reveal millions in overcharges by Medicare Advantage plans

Taxpayers footed the bill for care that should have cost far less, according to records released under the Freedom of Information Act. The U.S. government may charge insurers $650 million as a result.

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By:
  • Fred Schulte and
  • Holly K. Hacker
Medicare Advantage health plans have enrolled nearly 27 million members, or about 45% of people eligible for Medicare. A recent analysis finds Medicare overpaid the private health plans by more than $106 billion from 2010 through 2019 because of the way the plans charge for sicker patients.

Medicare Advantage's cost to taxpayers has soared in recent years, research finds

An alternative to original Medicare, the private plans are run mostly by major insurers. A recent analysis estimates Medicare overpaid these insurers by $106 billion from 2010 through 2019.

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By:
  • Fred Schulte
A civil suit filed by the Justice Department this week links exaggerated patient bills to tens of millions of dollars in overcharges by Medicare Advantage plans. A data analytics team facilitated the fraud, the lawsuit alleges.

The DOJ Says A Data Mining Company Fabricated Medical Diagnoses To Make Money

In a civil suit filed this week, the Justice Department accuses a New York medical analytics company of helping a Medicare Advantage plan cheat taxpayers out of millions of dollars.

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By:
  • Fred Schulte
Medicare Advantage, a fast-growing private alternative to original Medicare, has <a href="https://www.ahip.org/7-things-you-need-to-know-about-medicare-advantage/">enrolled</a> more than 26 million people. Humana Inc. is one of the largest of these insurers. While popular with seniors, Medicare Advantage has been the target of multiple government investigations.

Humana Inc. Overcharged Medicare Nearly $200 Million, Federal Audit Finds

If the report by the U.S. Department of Health and Human Services' Office of Inspector General is sustained, Humana Inc. could face a record penalty for overcharges in a Medicare Advantage plan.

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By:
  • Fred Schulte