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The Latest Breaking News from Medicare Advantage

How Medicare Advantage plans dodged auditors and overcharged taxpayers by millions

In April 2016, government auditors asked a Blue Cross Medicare Advantage health plan in Minnesota to turn over medical records of patients treated by a podiatry practice whose owner had been indicted for fraud.

Tribune News Service

A frozen capital market and an insurance premium shock: 10 health care predictions for 2023 from top investors

Distressed deals, inflation in insurance premiums, and restrictions on transgender treatments. Here's what the health care sector will look like in 2023, according to top investors.

Fortune

Medicare Advantage health plans dodged auditors, overcharged taxpayers millions

A review of 90 government audits reveals the plans have repeatedly tried to get around mandates to document medical conditions the government paid them to treat.

Chicago Sun-Times

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The Medicare Advantage plan scandal

Health insurers that issue Medicare Advantage plans have repeatedly tried to sidestep regulations, audits find

Salon

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.

WEKU

Over-the-counter hearing aids are here: everything you need to know

First made available in October for adults with mild to moderate hearing loss, they’re cheaper and easier to get. Here’s a guide to who can use them and how to get them.

Chicago Sun-Times

FDA change ushers in cheaper, easier-to-get hearing aids

It's now a lot easier and cheaper for Americans to get hearing aids

The Independent UK

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Audits — hidden until now — reveal millions in Medicare Advantage overcharges

Newly released federal audits reveal widespread overcharges and other errors in payments to Medicare Advantage health plans for seniors, with some plans overbilling the government more than $1,000 per patient a year on average.

Tribune News Service

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.

WEKU

5 mistakes you’re making with Medicare open enrollment

Millions of retirees are in the thick of Medicare open enrollment, which runs from Oct. 15 to Dec. 7, but many find the process challenging

The Independent UK

Medicare phone scammers want to slash your benefits and leave you with fewer in-network providers

You answer the phone and you’re greeted by a weird tone, followed by a few seconds of silence.

Tribune News Service

Medicare enrollees warned about deceptive marketing schemes

With Medicare’s open enrollment underway, health experts are warning older adults about an uptick in misleading marketing tactics that might lead some to sign up for Medicare Advantage plans that don’t cover their doctors or prescriptions and drive up their out-of-pocket costs

The Independent UK

This open enrollment season, look out for health insurance that seems too good to be true

It took nearly a year for Kelly Macauley to realize the health plan she bought while shopping for insurance coverage last October was not, in fact, insurance. Sure, red flags popped up along the way, but when she called to complain, she said, she was met with explanations that sounded…

Tribune News Service

Medicare Open Enrollment Occurs Annually from October to December — Here's What You Need to Know

Medicare open enrollment is underway. Here's what you need to get done.

Kiplinger

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Tribune News Service

Nursing home surprise: Advantage plans may shorten stays to less time than Medicare covers

After 11 days in a St. Paul, Minnesota, skilled nursing facility recuperating from a fall, Paula Christopherson, 97, was told by her insurer that she should return home.

Tribune News Service

In major retreat, Bright Health halts individual health insurance coverage

Bright Health Group will end individual and family health insurance coverage and reduce its Medicare Advantage coverage to just two states, steps that will cut its revenue in half.

The Independent UK

How to change Medicare plans — and why you might want to

Medicare open enrollment starts soon, but 7 in 10 Medicare beneficiaries say they don’t compare Medicare plans during this period, which stretches from Oct. 15 to Dec. 7

Chicago Sun-Times

Nursing home surprise: Medicare Advantage plans covering less time than Medicare covers

Health care providers, nursing home representatives and patient advocates say Medicare Advantage plans increasingly are ending members’ coverage for nursing home and rehabilitation services before patients are healthy enough to go home.

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The Independent UK

Exercise caution with zero-premium Medicare Advantage plans

Health insurers will flood the Medicare Advantage market again this fall with enticing offers of plans that have no monthly price tag

Tribune News Service

Walmart, UnitedHealth Group announce a partnership on clinic care and Medicare Advantage coverage

UnitedHealth Group and Walmart on Wednesday announced a 10-year health care partnership that will begin with enhancements for 15 clinics in the southeast U.S. as well as the launch of a co-branded Medicare Advantage health plan.

Chicago Sun-Times

Medicare Advantage plans face criticism at congressional hearing for denying care, overcharging

Witnesses sharply criticized the fast-growing health plans, citing audits and other reports that described plans denying access to health care.

Tribune News Service

Government watchdogs attack Medicare Advantage for denying care and overcharging

Congress should crack down on Medicare Advantage health plans for seniors that sometimes deny patients vital medical care while overcharging the government billions of dollars every year, government watchdogs told a House panel this week.

Tribune News Service

Why so slow? Legislators take on insurers’ delays in approving prescribed treatments

Andrew Bade, who was diagnosed with Type 1 diabetes nearly two decades ago, is accustomed to all the medical gear he needs to keep his blood sugar under control. His insulin pump contains a disposable insulin cartridge, and a plastic tubing system with an adhesive patch keeps in place the…

Benzinga

EXCLUSIVE: Skylight Health To Buy NeighborMD To Expand In Florida, Enter Medicare Advantage Global Risk

Skylight Health Group Inc (NASDAQ: SLHG) has agreed to acquire NeighborMD (NMD) for $8 million. Skylight has also arranged a $20 million debt line facility with a New York-based credit lender.

Chicago Sun-Times

Medicare Advantage plans denied nearly 1 in 5 claims that should have been paid, HHS finds

The agency’s inspector general found that private Medicare Advantage plans denied 18% of claims allowed under Medicare rules —often because of the insurers’ errors in processing claims.

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