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      medicare advantage

      U.S. Health and Human Services Secretary Xavier Becerra testifies

      'Bending the Knee' to Insurance Lobby, Biden Admin Delays Medicare Advantage Reforms

      "Medicare Advantage providers whined for months that they simply couldn't survive without being able to rip off the government, so the government said 'you can rip us off for just a little longer,'" said one critic.

      Jake Johnson
      Apr 01, 2023

      The Biden administration announced Friday that it will allow Medicare Advantage plans to continue overbilling the federal government in the short term after the insurance industry lobbied aggressively against proposed rule changes aimed at cracking down on fraud in the privately run program.

      The Centers for Medicare and Medicaid Services (CMS) said it is still moving ahead with the changes despite industry pressure to drop or completely overhaul them.

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      medicare advantage
      A demonstrator is seen holding a sign outside of a hearing at New York City Hall

      Biden Urged to Crack Down on 'Terrifying' Use of AI by Medicare Advantage Insurers

      "Robots should not be making life-or-death decisions," said healthcare campaigner Ady Barkan.

      Jake Johnson
      Mar 27, 2023

      Sen. Elizabeth Warren joined healthcare campaigner Ady Barkan and others on Monday in sounding alarm over a recent investigation showing that Medicare Advantage insurers are using unregulated artificial intelligence systems to determine when to end payments for patients' treatments, a practice that has prematurely terminated coverage for vulnerable seniors.

      STATreported earlier this month that while "health insurance companies have rejected medical claims for as long as they've been around," AI is "driving their denials to new heights in Medicare Advantage," a privately run program funded by the federal government.

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      medicare advantage
      Sens. Jeff Merkley and Elizabeth Warren speak before a hearing

      Senate Dems Blast Medicare Advantage Giants Over 'Exorbitant' CEO Pay

      "It is outrageous that industry groups, on your behalf, are putting your plan's enormous profits over care for seniors," wrote Sens. Elizabeth Warren and Jeff Merkley.

      Jake Johnson
      Mar 24, 2023

      Sens. Elizabeth Warren and Jeff Merkley are calling attention to the massive profits and "exorbitant" executive salaries of top Medicare Advantage insurers such as UnitedHealthcare and Humana, which are leading a lobbying blitz against efforts to combat widespread fraud in the privately run healthcare program.

      “In 2022, the seven major Medicare Advantage health care insurers—UnitedHealthcare, CVS/Aetna, Cigna, Elevance Health, Humana, Centene, and Molina—brought in revenues of $1.25 trillion and reported total profits of $69.3 billion, a 287% increase in profits since 2012," the Democratic senators wrote in recent letters to the companies' CEOs, citing an analysis by Wendell Potter of the Center for Health and Democracy.

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