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The Latest Breaking News from Medicare Advantage

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

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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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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.

Tribune News Service

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

The Independent UK

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.

Chicago Sun-Times

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

The Independent UK

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.

Tribune News Service

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.

Chicago Sun-Times

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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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Benzinga

Humana Q1 Earnings Beats Expectations, Raises FY22 Profit Guidance

Humana Inc (NYSE:HUM) has posted Q1 adjusted sales of $24.08 billion, beating the consensus of $23.51 billion. The benefits expense ratio increased from 86.4% to 85.9%, and the operating cost ratio increased from 12% to 9.7%. Humana posted an adjusted EPS of $8.04, beating the consensus of $6.78 and $6.38 posted a…

Tribune News Service

Denunciantes dicen que las aseguradoras de salud estafan a Medicare para ganar miles de millones

Teresa Ross llevaba meses planteando objeciones en el trabajo cuando sus jefes trajeron a un psicólogo con la esperanza de hacerle cuestionar su propia cordura.

Benzinga

UBS Upgrades Rating to Buy for Humana, Raises Price Target To $520

UBS upgraded its rating of Humana (NYSE:HUM) to Buy with a price target of $520.00, changing its price target from $486.00 to $520.00. Shares of Humana are trading up 2.2% over the last 24 hours, at $458.92 per share. A move to $520.00 would account for a 13.31% increase from…

Tribune News Service

Whistleblowers say health insurers are scamming Medicare to make billions

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.

Kiplinger

The Rules for Making a Medigap Switch

Kiplinger provides guidance on how to make a Medicare Medigap switch to get the best plan for your budget.

Benzinga

Albertsons Allows Customers To Use Supplemental Benefits To Buy Products

Albertsons Companies Inc (NYSE:ACI) customers can use supplemental benefits to purchase over-the-counter medications and fresh produce in the company's stores. The program provides access to customers using pre-paid cards funded by Medicare Advantage plans, employer incentives, healthcare providers, or local governments. The company has partnered with technology payments platforms such as Solutran's S3…

Tribune News Service

Medicare Advantage plans send pals to seniors’ homes for companionship — and profits

Widowed and usually living alone, Gloria Bailey walks with a cane after two knee replacement surgeries and needs help with housekeeping.

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