Medicare and Medicare Advantage stories

Updated Nov. 12, 2024

https://www.medpagetoday.com/people/cc2652/cheryl-clark

Nov. 8, 2024 • MedPAC Tackles Accuracy of Medicare Advantage Network Directories
— Providers can change any time, leaving patients anxious and stranded, commissioners say
https://tinyurl.com/yc693h7z

Oct. 11, 2024 • MedPAC Commissioners Pan Some Medicare Advantage Plans’ ‘Extra Benefits’
— Services cost Medicare an extra $83B in 2024; are debit cards and groceries really healthcare?
https://tinyurl.com/2s4hy87d

Oct. 11, 2024 • Payments to Medicare Plan Brokers Need Reform, MedPAC Says
— No preferential treatment should be given for enrolling people in Medicare Advantage, they argue
https://tinyurl.com/4s4652be

by Joyce Frieden, but I contributed

June 5, 2024 • Medicare Watchdog Seats Have Gone Unfilled for Nearly a Decade
— Medicare, Social Security public trustees are supposed to safeguard reports’ accuracy
https://tinyurl.com/3yj299tj

April 15, 2024 • MedPAC Wrestles With Wide Variation in Generic Rx Prices, Availability
— Commissioners baffled by factors affecting Part D drug prices
https://tinyurl.com/mryx99kz

March 15, 2024 • MedPod Today: AAMC Leaked Emails; ‘Wild West’ of Ketamine; MA Games the System
— MedPage Today reporters offer further insights on these recently covered topics
https://tinyurl.com/yhk2bjzh

March 15, 2024 • MedPAC’s Report Recommends Pay Changes for Healthcare Services
— Report highlights MA quality, overpayment issues, and urges action on four prior recommendations
https://tinyurl.com/5n8jw4se

March 11, 2024 • MedPAC Wrestles With How to Fix Deep Flaws in Medicare Advantage Quality Metrics
— Comparing MA plans with fee-for-service quality called “a hornet’s nest”
https://tinyurl.com/2xp6sd8u

March 7, 2024 • The Attitude with Arne Arnesen. Episode 418. Podcast on my interview with Don Berwick, MD, former head of the Centers for Medicare & Medicaid Services https://tinyurl.com/3tx44bte

March 1, 2024 • Obama CMS Chief: Medicare Advantage Plans Game the System
— Don Berwick says MA growth “should be slowed or stopped”
https://tinyurl.com/34s894zr

March 1, 2024 • MedPod episode on story, How Beneficiaries Really Feel About Medicare Advantage vs Traditional Medicare
— MA plans offer “extra benefits” but many go unused. Is Medicare Advantage really better?
https://tinyurl.com/3xz32w6a

Feb. 22, 2024 • How Beneficiaries Really Feel About Medicare Advantage vs Traditional Medicare
— MA plans offer “extra benefits” but many go unused. Is Medicare Advantage really better?
http://tinyurl.com/29y62pdd

Feb. 21, 2024 • There’s Still Time to Switch Medicare Advantage Plans This Year
— Beneficiaries have until March 31 to find a new plan; doctors should check plans, too
http://tinyurl.com/5f3hb62m

Feb. 9, 2024 • Senators Thrash Pharma CEOs for Pricing Drugs Higher in the U.S.
— Sen. Bernie Sanders blamed “corrupt” system, well-paid lobbyists
http://tinyurl.com/3j3mrv95

Feb. 2, 2024 • MEDPOD Episode on Michael Chernew interview
— MedPage Today reporters offer further insights on these recently covered topics
http://tinyurl.com/3tesdddu

Jan. 30, 2024 • The Attitude with Arne Arnesen. Discussion of recent interview with Michael Chernew, MedPAC chair, and asking if eventually, all seniors will have no choice but to be on Medicare Advantage
http://tinyurl.com/j8r4xhjs

Jan. 25, 2024 • Will All Seniors Eventually Have No Choice but Medicare Advantage?
— MedPAC chair discusses need to fix MA’s confusing limitations, upcoding, and rising costs
http://tinyurl.com/49zbxvw6

Jan. 16, 2024 • MedPAC Report on Medicare Advantage Growth, High Costs Generates Kerfuffle
— Commissioners reveal growing unease with MA practices: Not the “glowing success” everybody says
http://tinyurl.com/mryw4t2u

Nov. 27, 2023 • Hospitals Say Some Medicare Advantage Plans Are Skirting CMS Rules
— Groups lament stress to enrollees and billions in hospital losses from coverage delays, denials
https://tinyurl.com/3cb4jvsw

Nov. 13, 2023 • AMA Delegates Trash AI Bots, Medicare Advantage, Inexperienced ‘Politicized’ ALJs
— Proposal calls for facilities with an “Emergency Room” to have an emergency doc on site
https://tinyurl.com/bdeedjen

Nov. 9, 2023 • 10 Ways MedPAC Commissioners Think Regulators Should Fix Medicare Advantage Plans
— Improvements needed in network accuracy and transparency regarding denial rates, they say
https://tinyurl.com/2s4rzt3h

Nov. 7, 2023 • CMS Proposes Rule to Limit Medicare Advantage Plan Sales Commissions
— No more golf parties or free trips to brokers who “steer” beneficiaries to higher paying plans
https://tinyurl.com/yz3uje9z

Oct. 31, 2023 • HHS Proposes ‘Disincentive’ Penalties for Information-Blocking Providers
— Clinicians could see cuts in Medicare payments if found to have violated the rule
https://tinyurl.com/yvtvz8k8

Oct. 19, 2023 • Shady Medicare Advantage Plan Tactics Blasted at Senate Hearing
— “It’s a rip-off and it’s got to stop,” one Senator said
https://tinyurl.com/3j42akuc

Oct. 13, 2023 • UNC Health Publicly Threatens to Cancel UnitedHealthcare Contracts
— Letters blame improper denials, inadequate pay; patients urged to look for other plans for 2024
https://tinyurl.com/5b263f98

Sept. 28, 2023 • Blue Shield of California Has Fix for MA Enrollees Worried About Co-Pays
— An “underwriting holiday” doesn’t require supplemental plan applicants to answer health questions
https://tinyurl.com/kwz45jem

Sept. 25, 2023 • Two Large Medical Groups Shun Medicare Advantage Plans
— San Diego doctor groups latest to withdraw, citing low pay, prior authorization problems
https://tinyurl.com/sfc2edcf

Sept. 21, 2023 • Medicare Advantage Ads Should Look Different This Year
— KFF examines past predatory ads as new CMS regulation goes into effect
https://tinyurl.com/5xmtus3p

Sept. 14, 2023 • A ‘Sad’ Story: Patient Stuck With $176K Bill After Medicare Policy Switch
— CMS abruptly decided patients can self administer Stelara — even those with Parkinson’s
https://tinyurl.com/ytjhz6f7

May 18, 2023 • Congress Hearing Explores Medicare Advantage Routines That Deny, Delay Needed Care
— Blumenthal: “It’s fine, so long as you don’t need it for the big stuff”
https://bit.ly/41OkC1g

April 6, 2023 • CMS Cracks Down on Medicare Advantage Marketing, Prior Auth Practices
— Agency wants to stop schemes that mislead beneficiaries and prohibit unfair denials of care
https://bit.ly/3GngYU3

Feb. 28, 2023 • Philadelphia radio, Musical Innertube, airs a 40-minute podast with me talking about Medicare Advantage downsides and dirty little secrets.
https://bit.ly/3Y738eG

Feb. 28, 2023 • Medicare Plan Commissions May Steer Beneficiaries to Wrong Coverage
— Commonwealth Fund report: opaque, misaligned agent incentives influence enrollment choices
https://bit.ly/3mdU8Hi

Feb. 14, 2023 • Medicare Advantage Ads in Your Patient Portal? CMS Says They Shouldn’t Be There
— Patient outraged when portal mixed MA sales pitch with doctors’ notes
https://bit.ly/3IlpmVw

Jan. 31, 2023 • CMS Rule Means Medicare Advantage Plans Will Pay Back Billions in Overpayments
— Audits finding unsubstantiated claims will extrapolate overpayments to insurers’ other claims
https://bit.ly/3Hnp3aS

Jan. 26, 2023 • Medicare Part D Plan Prices May Change Unexpectedly
— How many seniors end up paying more than they thought they would?
https://bit.ly/3XRMVdw

Jan. 10, 2023 • Medicare Advantage Plans Take Top Spot in Shkreli Awards
— Lown president calls the list “a tragic comedy of grift and profiteering
https://bit.ly/3wb4Hwx

Dec. 8, 2022 • Should Doctors Warn Patients About the Downsides of Medicare Advantage Plans?
— Beneficiaries may not be aware of the plans’ limited networks or prior authorization rules
https://bit.ly/3PeuKeI

Nov. 14, 2022 • Expanding Vaccination Pay, ‘Public Option’ Fuel Debate Among AMA Delegates
— Resolutions also advocate for greater accuracy in Medicare Advantage plan offerings and more
https://bit.ly/3GdHFvd

Nov. 4, 2022 • Senate Report Decries Medicare Advantage Plan Marketing Deception
—Frustrated, confused, embarrassed enrollees often delay care after being “scammed,” report notes
https://bit.ly/3WA4zCw

Oct. 21, 2022 • CMS Puts the Kibosh on Misleading Medicare Advantage Sales Pitches
— “Secret shoppers” found that 80% of agent calls with clients were inaccurate or insufficient
https://bit.ly/3eRQYWk

Oct. 20, 2022 • Mayo Warns It Won’t Take Most Medicare Advantage Plans
– Letters to Florida, Arizona patients suggest they enroll in original Medicare with a supplement
https://bit.ly/3VKyHL9

Oct. 14, 2022 • Brokers Earn More to Steer New Beneficiaries to Medicare Advantage
— Agent says he would double earnings if he sold MA over Medigap plans to new clients
https://bit.ly/3TlHYat

Oct. 13, 2022 • The Medicare Advantage Trade-Off: Saving Money, Losing Access
— Beneficiaries may spend less on premiums, but care delays are common. Do worse outcomes follow?
https://bit.ly/3TgrkJq

Dec. 3, 2019 • Medicare Advantage Enrollees Discover Dirty Little Secret
— Getting out is a lot harder than getting in
https://bit.ly/2PKPfmx