'Americans should demand that the government stop rewarding Medicare Advantage plans for denying care inappropriately.'
Medicare Advantage plans are endangering the lives of older adults and people with disabilities. The HHS Office of the Inspector General , which works to fight waste, fraud and abuse, recently issued a devastatingshowing that these corporate health plans, which contract with the government to deliver Medicare benefits, are denying large amounts of care inappropriately.
This is not the first time that the OIG has raised serious concerns about Medicare Advantage. But Medicare Advantage plans continue to engage in widespread wrongful denials of care with little accountability. What will it take for the administration and Congress to protect people with Medicare from these bad actors?, the OIG raised equally troubling concerns about the risks faced by older adults and people with disabilities in Medicare Advantage.
The OIG report explains that because CMS pays Medicare Advantage plans a flat fee regardless of the amount they spend on care, they have a “potential incentive...to deny beneficiary access to services and deny payments to providers in an attempt to increase profits.” inappropriately denying potentially life-saving care to tens of thousands of older adults and people with disabilitiesThe OIG report finds that nearly one in seven Medicare Advantage plan denials of care are wrongful. It highlights inappropriate denials of costly tests, nursing home care, and rehabilitation services.
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