Tag Archives: MA Plans

[unable to retrieve full-text content]Brief commentary by Dr. Kahn who is in the thick of the discussion on Medicare Advantage Costs. Health Justice Monitor, Medicare Advantage Overpayment >$100 Billion, Jim (James G.) Kahn, MD, MPH Summary: Physicians for a National Health Program released a valuable summary of Medicare Advantage overpayments. The scope and scale is breathtaking: $100 billion annual payoff […] The post Payments to Medicare Advantage Plans is More Than What is...

[unable to retrieve full-text content]“Medicare Advantage: Questionable Use of Health Risk Assessments Continues to Drive Up Payments to Plans by Billions,” Office of Inspector General | Government Oversight | U.S. Department of Health and Human Services Why OIG Did This Review Medicare Advantage (MA) companies receive higher risk-adjusted payments from CMS for enrollees who are sicker, which helps to […] The post Questionable Use of Health Risk Assessments Drives Costs...

“Major Insurers Are Scamming Billions from Medicare, Whistle-Blowers Say” – PNHP, John Tozzi, Bloomberg, April 12, 2022 Teresa Ross had been raising objections at work for months when her bosses brought in a psychologist hoping to make her question her own sanity. A longtime manager at a Seattle health plan called Group Health Cooperative, Ross had opposed changes to the way the company billed Medicare. With the help of a new vendor, the...