REWahoo
Give me a museum and I'll fill it. (Picasso) Give
For those of you considering choosing Medicare Advantage plans vs Medicare Supplement (Medigap) plans:
THURSDAY, April 28, 2022 (HealthDay News) -- Coverage for eligible, necessary care is denied each year to tens of thousands of seniors with private Medicare Advantage plans, U.S. federal investigators say.
In a report released Thursday, the team from the inspector general's office of the U.S. Department of Health and Human Services said Medicare needs to improve oversight of these plans and strengthen enforcement against those private insurance companies with a pattern of improper denials of coverage.
The report also said that Advantage plans refused to pay about 18% of legitimate claims, about 1.5 million payments, in 2019. In some cases, plans ignored prior authorizations or other documentation to support the payment.
...the HHS findings challenge claims by the industry's main trade group that Medicare Advantage "delivers better services, better access to care and better value."
Instead, the investigators said they found "widespread and persistent problems related to inappropriate denials of services and payment."