11/04/2022
Buyer Beware! Many Medicare Advantage Plans are being sued by the Federal Government for fraudulent activity. They label patients as being sicker than they really are in order to get a higher fee from Medicare to treat the patient. The Advantage Plan is paid more by Medicare to cover a patient with more severe diagnoses than a patient who is healthier. They are draining our Medicare funds while paying providers (doctors and physical therapists, etc.) less than what we are normally reimbursed by regular Medicare coverage. As providers, if we accept Medicare, then we must accept these plans as well. Yes, the patient pays less, but their coverage is more restricted than if they had regular Medicare. And at what cost to the Medicare program as a whole?
The report by Senate Democrats points to widespread misbehavior by the plans and the marketing firms they hire.