Why Medicare Advantage costs taxpayers billions more than it should

[Penelope]

In South Florida, one of the nation’s top privately-run Medicare insurance plans faces a federal investigation into allegations that it overbilled the government by exaggerating how sick some of its patients were.

In the Las Vegas area, private health care plans for seniors ran up more than $100 million in added Medicare charges after asserting patients they signed up also were much sicker than normal — a claim many experts have challenged.

In Rochester, New York, a Medicare plan was paid $41 million to treat people with serious diseases — even though the plan couldn’t prove the patients in fact had those diseases.

These health plans and hundreds of others are part of Medicare Advantage, a program created by Congress in 2003 to help stabilize health care spending on the elderly. But the plans have sharply driven up costs in many parts of the United States — larding on tens of billions of dollars in overcharges and other suspect billings based in part on inflated assessments of how sick patients are, an investigation by the Center for Public Integrity has found.

Dominated by private insurers, Medicare Advantage now covers nearly 16 million Americans at a cost expected to top $150 billion this year.

Why Medicare Advantage costs taxpayers billions more than it should

Its time to get rid of the middle man and get rid of health insurance companies. How is the gov. subsidizing private companies (usually public corps) any different than subsidizing health care for its citizens and these companies make millions.
Yes Medicare pays Medicare Advantage plans money each month for each person they sign up. In most places citizens still need to pay their Medicare part b payment out of their SS checks and a payment to the Medicare Advantage company and most plans have copays and OOP max.

WE are being screwed every which way , we pay taxes to subsidize the health insurance companies and make their CEO's rich. BCBS in MI made 17 million last year if I remember right.

 

[debbiedowner]

In South Florida, one of the nation’s top privately-run Medicare insurance plans faces a federal investigation into allegations that it overbilled the government by exaggerating how sick some of its patients were.

In the Las Vegas area, private health care plans for seniors ran up more than $100 million in added Medicare charges after asserting patients they signed up also were much sicker than normal — a claim many experts have challenged.

In Rochester, New York, a Medicare plan was paid $41 million to treat people with serious diseases — even though the plan couldn’t prove the patients in fact had those diseases.

These health plans and hundreds of others are part of Medicare Advantage, a program created by Congress in 2003 to help stabilize health care spending on the elderly. But the plans have sharply driven up costs in many parts of the United States — larding on tens of billions of dollars in overcharges and other suspect billings based in part on inflated assessments of how sick patients are, an investigation by the Center for Public Integrity has found.

Dominated by private insurers, Medicare Advantage now covers nearly 16 million Americans at a cost expected to top $150 billion this year.

Why Medicare Advantage costs taxpayers billions more than it should

Its time to get rid of the middle man and get rid of health insurance companies. How is the gov. subsidizing private companies (usually public corps) any different than subsidizing health care for its citizens and these companies make millions.
Yes Medicare pays Medicare Advantage plans money each month for each person they sign up. In most places citizens still need to pay their Medicare part b payment out of their SS checks and a payment to the Medicare Advantage company and most plans have copays and OOP max.

WE are being screwed every which way , we pay taxes to subsidize the health insurance companies and make their CEO's rich. BCBS in MI made 17 million last year if I remember right.

As far as I know there is no billing of Medicare if you are on a MAPD plan, that is what the $850 or so a month they pay to them is take over your health care. Yes there are some instances (very few) when on an MAPD plan that Medicare Part B will will take over, hospice and certain drugs in the hospital. Now there are some MAPD's that were put together from groups of doctor's or hospitals and may have a different arrangement than Actual insurance companies.

I don't dispute there is fraud in MAPD there is just as much or more with original Medicare.

 

[Doc1]

In South Florida, one of the nation’s top privately-run Medicare insurance plans faces a federal investigation into allegations that it overbilled the government by exaggerating how sick some of its patients were.

In the Las Vegas area, private health care plans for seniors ran up more than $100 million in added Medicare charges after asserting patients they signed up also were much sicker than normal — a claim many experts have challenged.

In Rochester, New York, a Medicare plan was paid $41 million to treat people with serious diseases — even though the plan couldn’t prove the patients in fact had those diseases.

These health plans and hundreds of others are part of Medicare Advantage, a program created by Congress in 2003 to help stabilize health care spending on the elderly. But the plans have sharply driven up costs in many parts of the United States — larding on tens of billions of dollars in overcharges and other suspect billings based in part on inflated assessments of how sick patients are, an investigation by the Center for Public Integrity has found.

Dominated by private insurers, Medicare Advantage now covers nearly 16 million Americans at a cost expected to top $150 billion this year.

Why Medicare Advantage costs taxpayers billions more than it should

Its time to get rid of the middle man and get rid of health insurance companies. How is the gov. subsidizing private companies (usually public corps) any different than subsidizing health care for its citizens and these companies make millions.
Yes Medicare pays Medicare Advantage plans money each month for each person they sign up. In most places citizens still need to pay their Medicare part b payment out of their SS checks and a payment to the Medicare Advantage company and most plans have copays and OOP max.

WE are being screwed every which way , we pay taxes to subsidize the health insurance companies and make their CEO's rich. BCBS in MI made 17 million last year if I remember right.

" Many seniors choose the managed-care Medicare Advantage option instead of the traditional government-run Medicare program because it fills gaps in coverage, can cost less in out-of-pocket expenses and offers extra benefits, such as dental and eye care."

MA plans are bullshit. They are mostly closed HMO plans with NO out of area coverage except for Emergency. They typically charge no premium.

 

[debbiedowner]

In South Florida, one of the nation’s top privately-run Medicare insurance plans faces a federal investigation into allegations that it overbilled the government by exaggerating how sick some of its patients were.

In the Las Vegas area, private health care plans for seniors ran up more than $100 million in added Medicare charges after asserting patients they signed up also were much sicker than normal — a claim many experts have challenged.

In Rochester, New York, a Medicare plan was paid $41 million to treat people with serious diseases — even though the plan couldn’t prove the patients in fact had those diseases.

These health plans and hundreds of others are part of Medicare Advantage, a program created by Congress in 2003 to help stabilize health care spending on the elderly. But the plans have sharply driven up costs in many parts of the United States — larding on tens of billions of dollars in overcharges and other suspect billings based in part on inflated assessments of how sick patients are, an investigation by the Center for Public Integrity has found.

Dominated by private insurers, Medicare Advantage now covers nearly 16 million Americans at a cost expected to top $150 billion this year.

Why Medicare Advantage costs taxpayers billions more than it should

Its time to get rid of the middle man and get rid of health insurance companies. How is the gov. subsidizing private companies (usually public corps) any different than subsidizing health care for its citizens and these companies make millions.
Yes Medicare pays Medicare Advantage plans money each month for each person they sign up. In most places citizens still need to pay their Medicare part b payment out of their SS checks and a payment to the Medicare Advantage company and most plans have copays and OOP max.

WE are being screwed every which way , we pay taxes to subsidize the health insurance companies and make their CEO's rich. BCBS in MI made 17 million last year if I remember right.

" Many seniors choose the managed-care Medicare Advantage option instead of the traditional government-run Medicare program because it fills gaps in coverage, can cost less in out-of-pocket expenses and offers extra benefits, such as dental and eye care."

MA plans are bullshit. They are mostly closed HMO plans with NO out of area coverage except for Emergency. They typically charge no premium.

Depending on where you're located. I'm on a PPO. Won't get an HMO simply because no out of network coverage except for emergencies. I do pay a little premium.

Doesn't PPO's MAPD's pay the Medicare fee schedule? They're suppose to.

 

[Doc1]

In South Florida, one of the nation’s top privately-run Medicare insurance plans faces a federal investigation into allegations that it overbilled the government by exaggerating how sick some of its patients were.

In the Las Vegas area, private health care plans for seniors ran up more than $100 million in added Medicare charges after asserting patients they signed up also were much sicker than normal — a claim many experts have challenged.

In Rochester, New York, a Medicare plan was paid $41 million to treat people with serious diseases — even though the plan couldn’t prove the patients in fact had those diseases.

These health plans and hundreds of others are part of Medicare Advantage, a program created by Congress in 2003 to help stabilize health care spending on the elderly. But the plans have sharply driven up costs in many parts of the United States — larding on tens of billions of dollars in overcharges and other suspect billings based in part on inflated assessments of how sick patients are, an investigation by the Center for Public Integrity has found.

Dominated by private insurers, Medicare Advantage now covers nearly 16 million Americans at a cost expected to top $150 billion this year.

Why Medicare Advantage costs taxpayers billions more than it should

Its time to get rid of the middle man and get rid of health insurance companies. How is the gov. subsidizing private companies (usually public corps) any different than subsidizing health care for its citizens and these companies make millions.
Yes Medicare pays Medicare Advantage plans money each month for each person they sign up. In most places citizens still need to pay their Medicare part b payment out of their SS checks and a payment to the Medicare Advantage company and most plans have copays and OOP max.

WE are being screwed every which way , we pay taxes to subsidize the health insurance companies and make their CEO's rich. BCBS in MI made 17 million last year if I remember right.

" Many seniors choose the managed-care Medicare Advantage option instead of the traditional government-run Medicare program because it fills gaps in coverage, can cost less in out-of-pocket expenses and offers extra benefits, such as dental and eye care."

MA plans are bullshit. They are mostly closed HMO plans with NO out of area coverage except for Emergency. They typically charge no premium.

Depending on where you're located. I'm on a PPO. Won't get an HMO simply because no out of network coverage except for emergencies. I do pay a little premium.

Doesn't PPO's MAPD's pay the Medicare fee schedule? They're suppose to.

All of Medicare works on a fee schedule. I refuse to sell Med Advantage plans. The ONLY reason to buy one is because one can't afford a supplemental plan.

 

[healthmyths]

In South Florida, one of the nation’s top privately-run Medicare insurance plans faces a federal investigation into allegations that it overbilled the government by exaggerating how sick some of its patients were.

In the Las Vegas area, private health care plans for seniors ran up more than $100 million in added Medicare charges after asserting patients they signed up also were much sicker than normal — a claim many experts have challenged.

In Rochester, New York, a Medicare plan was paid $41 million to treat people with serious diseases — even though the plan couldn’t prove the patients in fact had those diseases.

These health plans and hundreds of others are part of Medicare Advantage, a program created by Congress in 2003 to help stabilize health care spending on the elderly. But the plans have sharply driven up costs in many parts of the United States — larding on tens of billions of dollars in overcharges and other suspect billings based in part on inflated assessments of how sick patients are, an investigation by the Center for Public Integrity has found.

Dominated by private insurers, Medicare Advantage now covers nearly 16 million Americans at a cost expected to top $150 billion this year.

Why Medicare Advantage costs taxpayers billions more than it should

Its time to get rid of the middle man and get rid of health insurance companies. How is the gov. subsidizing private companies (usually public corps) any different than subsidizing health care for its citizens and these companies make millions.
Yes Medicare pays Medicare Advantage plans money each month for each person they sign up. In most places citizens still need to pay their Medicare part b payment out of their SS checks and a payment to the Medicare Advantage company and most plans have copays and OOP max.

WE are being screwed every which way , we pay taxes to subsidize the health insurance companies and make their CEO's rich. BCBS in MI made 17 million last year if I remember right.

" Many seniors choose the managed-care Medicare Advantage option instead of the traditional government-run Medicare program because it fills gaps in coverage, can cost less in out-of-pocket expenses and offers extra benefits, such as dental and eye care."

MA plans are bullshit. They are mostly closed HMO plans with NO out of area coverage except for Emergency. They typically charge no premium.

No they are NOT Health Maintenance Organizations!
They manage the Medicare beneficiary like me on the $800/month paid them by Medicare. And they do it BETTER then traditional FISS Medicare!
Again you have such little knowledge compared to mine. It is pathetic.

 

[Penelope]

In South Florida, one of the nation’s top privately-run Medicare insurance plans faces a federal investigation into allegations that it overbilled the government by exaggerating how sick some of its patients were.

In the Las Vegas area, private health care plans for seniors ran up more than $100 million in added Medicare charges after asserting patients they signed up also were much sicker than normal — a claim many experts have challenged.

In Rochester, New York, a Medicare plan was paid $41 million to treat people with serious diseases — even though the plan couldn’t prove the patients in fact had those diseases.

These health plans and hundreds of others are part of Medicare Advantage, a program created by Congress in 2003 to help stabilize health care spending on the elderly. But the plans have sharply driven up costs in many parts of the United States — larding on tens of billions of dollars in overcharges and other suspect billings based in part on inflated assessments of how sick patients are, an investigation by the Center for Public Integrity has found.

Dominated by private insurers, Medicare Advantage now covers nearly 16 million Americans at a cost expected to top $150 billion this year.

Why Medicare Advantage costs taxpayers billions more than it should

Its time to get rid of the middle man and get rid of health insurance companies. How is the gov. subsidizing private companies (usually public corps) any different than subsidizing health care for its citizens and these companies make millions.
Yes Medicare pays Medicare Advantage plans money each month for each person they sign up. In most places citizens still need to pay their Medicare part b payment out of their SS checks and a payment to the Medicare Advantage company and most plans have copays and OOP max.

WE are being screwed every which way , we pay taxes to subsidize the health insurance companies and make their CEO's rich. BCBS in MI made 17 million last year if I remember right.

" Many seniors choose the managed-care Medicare Advantage option instead of the traditional government-run Medicare program because it fills gaps in coverage, can cost less in out-of-pocket expenses and offers extra benefits, such as dental and eye care."

MA plans are bullshit. They are mostly closed HMO plans with NO out of area coverage except for Emergency. They typically charge no premium.

No they are NOT Health Maintenance Organizations!
They manage the Medicare beneficiary like me on the $800/month paid them by Medicare. And they do it BETTER then traditional FISS Medicare!
Again you have such little knowledge compared to mine. It is pathetic.

Perhaps yours does which is in a few counties in FL but in MI they suck. One can end up paying much more OOP in a year than the cost of a medigap plan.

 

[Mac1958]

MA plans are an excellent option to Medicare Supplement plans.

They function essentially as a PPO or HMO for those who don't need or don't want to pay for a Medicare Supplement PLUS a PDP.

They give seniors a choice in how they cover themselves.

All Americans should be in the Medicare/Medicare Supplement/Medicare Advantage system.
.

 

[Mac1958]

One can end up paying much more OOP in a year than the cost of a medigap plan.

Yes, that is possible, but they also have out-of-pocket maximums. Medicare alone does not. That's the choice you make when you're shopping Medicare Supplements vs. Medicare Advantage plans: Do I want to pay as I go, if I go, or do I want to just pay more monthly and not worry about OOP?

That's a good choice to have. Choice is good.
.

 

[JoeB131]

MA plans are an excellent option to Medicare Supplement plans.

They function essentially as a PPO or HMO for those who don't need or don't want to pay for a Medicare Supplement PLUS a PDP.

They give seniors a choice in how they cover themselves.

All Americans should be in the Medicare/Medicare Supplement/Medicare Advantage system.

No, we need to go to single payer, and get private insurance companies out of health care altogether.

 

[Political Junky]

MA plans are an excellent option to Medicare Supplement plans.

They function essentially as a PPO or HMO for those who don't need or don't want to pay for a Medicare Supplement PLUS a PDP.

They give seniors a choice in how they cover themselves.

All Americans should be in the Medicare/Medicare Supplement/Medicare Advantage system.

No, we need to go to single payer, and get private insurance companies out of health care altogether.

The insurance companies give so much to Congress .. makes that difficult for congressmen to give up.

 

[JoeB131]

The insurance companies give so much to Congress .. makes that difficult for congressmen to give up.

And that's the problem. The Health Insurance INdustry wouldn't last one day without government support, and single payer would be cheaper and more humane. But as long as both parties are on the take, this isn't going to get fixed

 

[healthmyths]

MA plans are an excellent option to Medicare Supplement plans.

They function essentially as a PPO or HMO for those who don't need or don't want to pay for a Medicare Supplement PLUS a PDP.

They give seniors a choice in how they cover themselves.

All Americans should be in the Medicare/Medicare Supplement/Medicare Advantage system.

No, we need to go to single payer, and get private insurance companies out of health care altogether.

NO we do not need to destroy 1,400 companies that employ 450,000 people and PAY $100 billion a year in taxes. That is so stupid and for what reason?
Less then 2 million people that are not insured THAT WANT to be insured!
No the solution is already in existence for doctors that are under federal contract and it is known as the1946 Federal Tort Claims Act. "
And 90% of doctors surveyed AGREE!
Nearly $850 BILLION A year...in wasted duplicate testing, referrals all known as "DEFENSIVE MEDICINE PRACTICE"!

Read the below study where 90% of physicians surveyed say they order $850 billion a year in wasted duplicate tests, referrals all out of FEAR of being SUED!
--- Emergency medicine, primary care, and OB/GYN physicians are most likely to practice defensive medicine.
--- 79 to 83% of surgeons and OB/GYNs have been named in lawsuits.
http://www.jacksonhealthcare.com/media/8968/defensivemedicine_ebook_final.pdf

So why do people like you defend this wasteful practice which insurance companies don't care they just pay the claims and raise the premiums.

If lawyers were taxed like tanning salons were in Obamacare 10% that $27 Billion a year in tax would pay a $5,000 premium for each of the 5 million supposedly mean tested
Americans that don't have insurance.
PROBLEM solved!

 

[Penelope]

There is massive fraud in Medicare, Medicaid and MA billing, and while some are errors, most is intentional:

Washington, DC-America's taxpayers could see several billion in misspent Medicare, Medicaid and other health and human services dollars saved in fiscal 2016 as the result of work by the Office of the Inspector General (OIG) of the Department of Health and Human Services (HHS), according to a report released recently.

This year's Semiannual Report to Congress boasts expected recoveries of more than $5.66 billion in investigative and audit receivables compared to $3.35 billion last year.

Taxpayers Could See Billions Saved As the Result of HHS OIG Work, New Report Says

 

[healthmyths]

The insurance companies give so much to Congress .. makes that difficult for congressmen to give up.

And that's the problem. The Health Insurance INdustry wouldn't last one day without government support, and single payer would be cheaper and more humane. But as long as both parties are on the take, this isn't going to get fixed

So what do you do with 492,000 people that work in the health insurance business and will get 99 weeks at $400/week in unemployment insurance? How will you make up the $100 Billion a year in lost tax revenue paid to the federal government, state governments, local property taxes, all the empty office buildings.

 

[JoeB131]

NO we do not need to destroy 1,400 companies that employ 450,000 people and PAY $100 billion a year in taxes. That is so stupid and for what reason?

Because they are fucking evil?

Guy, you've never had to fight with an insurance company to get treatment AFTER they have your money. I have. My solution would to abolish private insurance and then harvest their executives for transplant organs, the only time those fucks would have ever contributed anything positive to health care in this country.

No the solution is already in existence for doctors that are under federal contract and it is known as the1946 Federal Tort Claims Act. "
And 90% of doctors surveyed AGREE!
Nearly $850 BILLION A year...in wasted duplicate testing, referrals all known as "DEFENSIVE MEDICINE PRACTICE"!

well, of course, Doctors would be LOVE to be free of fear of being held accountable for their own incompetence.

96,000 Americans die every year because of medical mistakes. Thousands more are maimed because of bad practices.

 

[JoeB131]

So what do you do with 450,000 people that work in the health insurance business and will get 100 weeks at $500/week in unemployment insurance?

Harvest them for transplant organs? Frankly, that's what I'd love to do to the little shit from Cigna who made me fight for a year to get my knee worked on.

On a serious note, most of these people can find other jobs.

You see, the problem is, these 450,000 parasites add nothing to the quality of health care. They don't treat one person.

How will you make up the $100 Billion a year in lost tax revenue paid to the federal government, state governments, local property taxes, all the empty office buildings.

Well, you see, here's the thing. When we pay 17% of our GDP on the bloated health insurance industry and the rest of the world is only spending 10% of their GDP, 7% of 15 Trillion is a HUGE savings.

 

[healthmyths]

So what do you do with 450,000 people that work in the health insurance business and will get 100 weeks at $500/week in unemployment insurance?

Harvest them for transplant organs? Frankly, that's what I'd love to do to the little shit from Cigna who made me fight for a year to get my knee worked on.

On a serious note, most of these people can find other jobs.

You see, the problem is, these 450,000 parasites add nothing to the quality of health care. They don't treat one person.

How will you make up the $100 Billion a year in lost tax revenue paid to the federal government, state governments, local property taxes, all the empty office buildings.

Well, you see, here's the thing. When we pay 17% of our GDP on the bloated health insurance industry and the rest of the world is only spending 10% of their GDP, 7% of 15 Trillion is a HUGE savings.

So your premise is a "Single payer" would cut ALL health care costs to 10%. Is that right?
With this as a resulting health care facility and health care right?

 

[Moonglow]

NO we do not need to destroy 1,400 companies that employ 450,000 people and PAY $100 billion a year in taxes. That is so stupid and for what reason?

Because they are fucking evil?

Guy, you've never had to fight with an insurance company to get treatment AFTER they have your money. I have. My solution would to abolish private insurance and then harvest their executives for transplant organs, the only time those fucks would have ever contributed anything positive to health care in this country.

No the solution is already in existence for doctors that are under federal contract and it is known as the1946 Federal Tort Claims Act. "
And 90% of doctors surveyed AGREE!
Nearly $850 BILLION A year...in wasted duplicate testing, referrals all known as "DEFENSIVE MEDICINE PRACTICE"!

well, of course, Doctors would be LOVE to be free of fear of being held accountable for their own incompetence.

96,000 Americans die every year because of medical mistakes. Thousands more are maimed because of bad practices.

Everytime I see two doctors consulting to gether, it makes me wonder why they don't invest in mortuaries..

 

[healthmyths]

NO we do not need to destroy 1,400 companies that employ 450,000 people and PAY $100 billion a year in taxes. That is so stupid and for what reason?

Because they are fucking evil?

Guy, you've never had to fight with an insurance company to get treatment AFTER they have your money. I have. My solution would to abolish private insurance and then harvest their executives for transplant organs, the only time those fucks would have ever contributed anything positive to health care in this country.

No the solution is already in existence for doctors that are under federal contract and it is known as the1946 Federal Tort Claims Act. "
And 90% of doctors surveyed AGREE!
Nearly $850 BILLION A year...in wasted duplicate testing, referrals all known as "DEFENSIVE MEDICINE PRACTICE"!

well, of course, Doctors would be LOVE to be free of fear of being held accountable for their own incompetence.

96,000 Americans die every year because of medical mistakes. Thousands more are maimed because of bad practices.

Everytime I see two doctors consulting to gether, it makes me wonder why they don't invest in mortuaries..

Hmmm... so these doctors are in favor of reducing their source of gross revenue, i.e. patient care ? Does that make sense?