Tag: Medicare

Biden Enables The Fraud

This is one of my FYI posts for I watch policies that could effect our seniors….the biggest thing that seniors need to be aware of is the ‘medicare advantage plans’….they are not all they are cracked up to be.

I have made my thoughts known about these so-called Medicare Advantage plans….I think it is taking advantage of seniors who are worried about their aging body.

But as usual the insurance industry has spent its cash well….all the facts point to these ‘advantage” plans are little more than a scam….the president has allowed this raping of seniors to continue.

Medicare Advantage providers whined for months that they simply couldn’t survive without being able to rip off the government, so the government said ‘you can rip us off for just a little longer,'” The American Prospect‘s David Dayen tweeted in response to the CMS announcement.

The changes involve tweaks to the Medicare Advantage risk-adjustment model, which determines how much the federal government pays insurers to cover patient care.

Medicare Advantage plans are notorious for piling on diagnoses to make patients appear sicker than they are to reap larger payments from the federal government. CMS estimates that overpayments to Medicare Advantage totaled $11.4 billion in fiscal year 2022, a sizeable drain on the Medicare trust fund.

“Nearly every large insurer in the program has settled or is facing a federal fraud lawsuit for such conduct,” The New York Timesnoted Friday. “Evidence of the overpayments has been documented by academic studies, government watchdog reports, and plan audits.”

…

Medicare Advantage insurers have been fighting the Biden administration’s proposed changes for months, running ads warning that the reforms would result in higher premiums and worse care for patients—claims that federal health officials adamantly rejected.

https://www.commondreams.org/news/biden-medicare-advantage-reforms

The lobbyists for the insurance industry has buckets on money to throw at Congress we, the people, do not.

Plus Wall Street is happy with the Biden decision….

UnitedHealth Group, a dominant force in the lucrative Medicare Advantage market, has seen its stock jump over the past week as Wall Street analysts and investors embrace the Biden administration’s decision to delay reforms aimed at tackling abuse in the privately run, government-funded health program.

STATreported late last week that “Wall Street was overjoyed” by the announcement from the Centers for Medicare and Medicaid Services (CMS), which said it would phase in changes to the model that dictates how much government funding Medicare Advantage insurers receive to cover patient care.

Instead of implementing the changes all at once, the Biden administration will roll out the reforms over a three-year period, allowing Medicare Advantage insurers to continue overbilling the federal government in the meantime.

https://www.commondreams.org/news/wall-street-biden-medicare-advantage

Oh there is AARP to protect seniors….that is a lie for they endorse a ‘plan’ that is scamming their members.

Please if you are considering one of these ‘plans’ think twice and check out the evidence before wasting your cash.

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Repubs Moves As Predicted

It is a well known fact that Repubs hate the idea of Social Security and Medicare and they attempt to de-fund as soon as they are in control of the House and 2023 is no exception….

House Republicans are making clear that they intend to seek cuts to entitlement programs like Social Security and Medicare with their new majority in the 118th Congress.

Their plans to target health care programs follow demands from a group of conservatives that helped elect House Speaker Kevin McCarthy (R-Calif.) over the weekend. Those far-right lawmakers have sought across-the-board spending cuts in order to tackle the growing national debt.

But the narrow House GOP majority ― McCarthy can afford to lose just four votes on any bill ― is far more divided on cuts to defense spending than for entitlement programs.

“I’m all for a balanced budget, but we’re not going to do it on the backs of our troops and our military,” Rep. Michael Waltz (R-Fla.), a former Army Green Beret, said Monday during an interview on Fox Business. “If we really want to talk about the debt and spending, it’s the entitlements programs.”

As part of his list of concessions to conservatives, McCarthy reportedly agreed to cap spending for the next year at fiscal 2022 levels, which would amount to over $130 billion in cuts from last month’s $1.7 trillion government funding bill.

Republicans don’t plan to alter benefits for current Social Security and Medicare recipients, according to Rep. Chip Roy (R-Texas).

“What we have been very clear about is, we’re not going to touch the benefits that are going to people relying on the benefits under Social Security and Medicare,” Roy said Sunday on CNN’s “State of the Union.” “But we all have to be honest about sitting at the table and figuring out how we’re going to make those work, how we’re going to deal with defense spending and how we’re going to deal with nondefense discretionary spending.”

The Republican Study Committee proposed a budget for fiscal 2023 that would gradually increase the eligibility ages for Social Security and Medicare, and change the Social Security benefit formula for people 54 and younger, while not changing it for people closer to receiving benefits.

Democrats are likely to oppose those changes, as well as any cuts to Social Security and Medicare, and an ensuing standoff could result in another government shutdown. The 2018-2019 lapse in federal funding lasted 35 days after a fight over former President Donald Trump’s border policies and immigration.

https://www.huffpost.com/entry/social-security-medicare-cuts-republicans_n_63bc41fbe4b0b2e15069b0ae

Seniors really should pay attention before they throw away their votes for those that will do them the most damage.

But will they?

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Labor And Medicare

It is just not the GOP that works to undermine the Medicare debate…..labor is not a friend of our seniors either.

I have a long history of defending the labor movement….but that does not extend to union leadership.

I have long been a critic of our so-called labor movement….as a past labor organizer I see the biggest problem as the US labor is more concerned with monetary issues when they should be focused on the political.

I recently saw some disturbing news about the labor issues on Medicare….

“Medicare is a pillar of the healthcare system”

– AFL-CIO June 13, 2022

Such a statement from the AFL-CIO would suggest that labor is determined to protect Medicare and even support improving and expanding it to all Americans. Additionally, President Biden and Democrats regularly criticize Republican threats to reauthorize and voucherize Medicare. Meanwhile, what’s left out of both the Democrat talking points and the AFL-CIO’s 2022 national resolution on healthcare is any acknowledgment that the real threat to Medicare and healthcare today is the decades-long tax-subsidized privatization supported by both major parties.

With major support from organized labor, including AFL-CIO President George Meany at the signing, Medicare was signed into law in 1965. Before Medicare, only 60% of those over 65 had insurance since it was unavailable or unaffordable via private insurance (seniors were charged 3x the rate of younger people). Not only economically beneficial to the working class, the passage of Medicare was a huge civil rights victory as payments to physicians, hospitals, and health care providers were conditional on desegregation.

While a big victory, Medicare did not provide full coverage for all services, and from its inception, there has been a drive to privatize and hand it over to profiteers. In fact, 2022 marks the 50th anniversary (1972) of Medicare permitting private insurance companies (HMOs) to participate in Medicare.

President Clinton finalized HMO participation with Congress in 1997, and in 2003, the Medicare Modernization Act, under President Bush, further boosted privatization. The year 2003 marks the beginning of Medicare Advantage plans: insurance companies essentially masquerading as Medicare.

HMOs and all the other private insurance companies introduced into Medicare after 1997 have not saved the government money, but instead, raised the cost to taxpayers much more than traditional Medicare beneficiaries. In 2005 the Government Accounting Office reported that “It is largely . . . excess payments, not managed care efficiencies, that enable plans to attract beneficiaries by offering a benefits package that is more comprehensive than the one available to FFS beneficiaries, while charging modest or no premiums. Nearly all of the 210 plans in our study received payments in 1998 that exceeded expected FFS costs….”

Labor Leaders Provide Cover for Privatization of Medicare

If the Dems/GOP and Labor have their way then Americans will get screwed (as usual) by those we trust the most.

Just to let my readers know…..

Biden campaigned to expand Medicaid. Now he’s signed a bill to sharply curtail it, ending coverage for millions of people in the middle of a pandemic he pretends is over…

The Social Security administration continues to deny thousands of disability claims a year, in part because it continues to rely on a 45-year-old list of outdated job titles. We live in a System that is eager to help the people who least need it and quick to ignore, chastise and punish the weakest, sickest and poorest among us.

More broken promises that our ‘trusted’ leaders throw out the window once elected.

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Medicare Advantage Plans

I know you have seen those Medicare Advantage plans on TV…..I have written what I think about these plans…in short a con job to separate seniors from their money….

Those MediCare Advantage Plans

It appears that Congress will attempt to investigate these scams….

The Biden administration on Wednesday proposed a ban on misleading ads for Medicare Advantage plans that have targeted older Americans and, in some cases, persuaded them to sign up for plans that don’t cover their doctors or prescriptions. The rule, proposed by the Centers for Medicare and Medicaid Services, would prohibit ads that market Medicare Advantage plans with confusing words, imagery, or logos. The rule also would ban ads that don’t specifically mention a health insurance plan by name, the AP reports.

It’s an aggressive step to tackle a growing problem in the Medicare Advantage marketplace, a booming business that offers privately run versions of the government’s Medicare program for people who are 65 and older or have disabilities. Nearly half of all Medicare enrollees—about 28 million—are now turning to Medicare Advantage plans. And some have been deceived by television commercials, online ads, and mailers put out by the marketing agencies and brokers that some insurers have hired to win over customers. The proposed rule “takes important steps to hold Medicare Advantage plans accountable for providing high quality coverage and care to enrollees,” said agency Administrator Chiquita Brooks-LaSure in a statement.

The problem has become so pervasive that CMS agents have been secretly shopping for plans by calling the phone numbers in advertisements, finding in some cases that brokers have overstated the benefits that enrollees would get and the money they would save in the new plans. Democrats on the Senate Finance Committee released an investigative report last month showing that several states also reported an increase in complaints about deceptive marketing schemes in 2021. “These proposals are an important step towards protecting seniors in Medicare from scammers and unscrupulous insurance companies and brokers,” the committee’s chairman, Democratic Sen. Ron Wyden, said in a statement on Wednesday.

Will this put a stop to these types of scams or is it just going through the motions to look like the government actually cares?

Whatcha think?

I Read, I Write, You Know

“lego ergo scribo”

Let’s Defraud Seniors

This is post is for all those Americans that have had their 50th birthday surely they have received their official letter inviting them to join AARP (where did they get your birthday info)……

The big deal these days is that Medicare Advantage plans for us pre-dementia seniors….to me they seem like a scam and not worth the cash they cost….seems I am not the only one with such thoughts….

I recently wrote about the deceptions that insurance companies are pulling on seniors…

Those MediCare Advantage Plans

Now further info has been given to help seniors know what is being done to rip them off…..

Insurance giants are exploiting Medicare Advantage—a corporate-managed program that threatens to result in the complete privatization of traditional Medicare—to capture billions of dollars in extra profits, Saturday reporting by The New York Times confirmed.

The newspaper’s analysis of dozens of lawsuits, inspector general reports, and watchdog investigations found that overbilling by Medicare Advantage (MA) providers is so pervasive it exceeds the budgets of entire federal agencies, prompting journalist Ryan Cooper to call the program “a straight up fraud scheme.”

Nearly half of Medicare’s 60 million beneficiaries are now enrolled in MA plans managed by for-profit insurance companies, and it is expected that most of the nation’s seniors will be ensnared in the private-sector alternative to traditional Medicare by next year. Six weeks ago, Sen. Ron Wyden (D-Ore.) launched an inquiry into “potentially deceptive” marketing tactics used by MA providers to “take advantage” of vulnerable individuals.

As the table below shows, almost every major player in the industry has been accused of fraud by a whistleblower or the U.S. government. In addition, the vast majority are engaged in rampant upcoding, or exaggerating patients’ illnesses in order to reap more money from taxpayers—something they do while refusing to provide necessary care for tens of thousands each year.

https://www.commondreams.org/news/2022/10/09/straight-fraud-data-confirms-private-insurers-use-medicare-advantage-steal-billions

Seniors should research this before they commit to a monthly deduction to their Social Security benefits.

Remember if something sounds too good to be true then it probably is just that….too good to be true.

Please do not fall for the glowing promos….you need to be more vigilant for these parasites will suck you monetarily dry.

I Read, I Write, You Know

“lego ergo scribo”

Those MediCare Advantage Plans

You have seen the ads…..everybody sells these plans, even AARP, that say they can put money back into your Social Security check….but what of these plans?

First of all the whole US health care system is a scam.

But what of these ‘advantage’ plans?

At least one Senator is not convinced these are anything but a deception….

Sen. Ron Wyden on Tuesday launched an inquiry into “potentially deceptive” marketing tactics being used by private insurers and other companies that offer Medicare benefits through Medicare Advantage and Part D prescription drug plans, citing “alarming reports” about contractors “engaging in aggressive sales practices that take advantage of vulnerable seniors and people with disabilities.”

In his capacity as chair of the Senate Finance Committee, which has jurisdiction over federal healthcare programs under the Social Security Act, including privately run Medicare Advantage (MA) and Part D drug plans, Wyden (D-Ore.) sent letters requesting more information from 15 state insurance commissioners and state health insurance assistance programs.

The letter—sent to officials in Arizona, California, Colorado, Florida, Georgia, Illinois, Massachusetts, Michigan, Missouri, New York, North Carolina, Ohio, Oregon, Pennsylvania, and Texas—comes amid a surge in complaints about MA and Part D marketing materials that purport to inform seniors of their coverage options.

In May, the Centers for Medicare & Medicaid Services (CMS), which has the authority to regulate materials used to market MA and Part D plans, reported that complaints from seniors more than doubled from 2020 to 2021.

…

Among other things, Wyden wants officials to provide data on the number of complaints about MA and/or Part D marketing materials they have received in 2019, 2020, 2021, and 2022, including possible patterns of discrimination, as well as “examples of potentially false or misleading marketing materials and advertisements in MA or Part D, including mailers, robo-calls, websites, television commercials, and online advertisements.”

Of Medicare’s 60 million beneficiaries, nearly half are enrolled in MA plans and 50 million are enrolled in Part D plans. Corporations that manage MA plans have come under fire for upcoding, or exaggerating patients’ illnesses in order to reap larger payments from the federal government—something they do while refusing to provide necessary care for tens of thousands each year.

https://www.commondreams.org/news/2022/08/23/wyden-launches-probe-deceptive-marketing-medicare-advantage-plans

So the question remains….is Medicare Advantage a necessary expense?  Is it a scam?

My thoughts are this is an unnecessary expense with promises that may not be realized or needed.

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“lego ergo scribo”

Closing Thought–27Jan22

Is Medicare paying for the Covid miracle cure?

Ivermictin?

That miracle of medical technology that has been pushed by idiots on the Right as a treatment for Covid.

Is Medicare on the hook for this pipe dream?

If you’re in the camp that believes ivermectin is a wonderful drug … for ailments other than COVID, a new Mother Jones article is likely to raise your ire. It flags a January study in the Journal of the American Medical Association that looked at just who is paying for the ivermectin doctors have been prescribing COVID patients despite the FDA’s warning that doing so is dangerous. The answer: well, you. A team led by Kao-Ping Chua of the University of Michigan’s School of Public Health looked at a sampling of Medicare Advantage claims (excluding ones involving patients who had a diagnosis code for a parasitic infection prior to filling the ivermectin prescription). They found that Medicare Advantage covered, on average, 74% of the cost of each ivermectin prescription, or $39 a pop.

The team added in what private insurers paid (61% of the cost) and arrived at a total of $2.5 million in insurance coverage per week, with Medicare’s portion of that being about $925,000. The researchers point out the total is an undercount because it doesn’t include Medicaid. “Findings suggest that insurers heavily subsidized the costs of ivermectin prescriptions for COVID-19, even though economic theory holds that insurers should not cover ineffective care,” they write. Mother Jones has this takeaway: “Chua’s findings are especially noteworthy when considering one of the main arguments of ivermectin proponents: The drug is cheap, often just a little more than a dollar a dose. Yet the study vividly illustrates that while individual costs can be low, on a population level, they add up fast.”

Forbes notes the researchers looked at private and Medicare plan spending during the week of Aug. 13, 2021, and “it’s not yet clear how ivermectin prescribing levels may have fluctuated after that week in August.” It adds another caveat, which is that the sample used wasn’t a random or nationally representative sample but a convenience sample, meaning a sample of the people who happened to be in the database used. The sample they ended up with had a higher proportion of people from the Midwest and a lower proportion from the South.

This needs a review.

The taxpayer does not need to be on the ook for bogus science.

I Read, I Write, You Know

“lego ergo scribo”

The Privatization Of Medicare

Since I can remember the GOP has hated the very idea of Medicare and almost every Congress they have worked tirelessly to try and give the health industry a win by privatizing the program.

Every year since the election of Reagan the foundation of Medicare has been chipped a way….then there is Biden……a president that is heavily invested in the chipping……

A Trump-era pilot program that could result in the complete privatization of traditional Medicare in a matter of years is moving ahead under the Biden administration, a development that—despite its potentially massive implications for patients across the U.S.—has received scant attention from the national press or Congress.

a group of physicians from around the nation will try to grab the notice of lawmakers, the Biden White House, and the public by traveling to Washington, D.C. and demanding that the Health and Human Services Department immediately stop the Medicare experiment, which is known as Direct Contracting (DC).

The doctors plan to present HHS with a petition signed by more than 1,500 physicians who believe the DC pilot threatens “the future of Medicare as we know it.”

Advocates have been publicly sounding the alarm about the DC program for months, warning that it could fully hand traditional Medicare over to Wall Street investors and other profit-seekers, resulting in higher costs for patients and lower-quality care.

https://www.commondreams.org/news/2021/11/30/congress-asleep-switch-biden-continues-trump-era-ploy-privatize-medicare

Once again the Democrats prove that they are NO better than the GOP….their concerns are for the donors NOT the people.

Medicare could be lost in the name of ‘compromise’ and word that does more damage than good.

At what point do the American people start paying attention to their future and stop living on social media for instant gratification?

The ONLY answer to getting proper health care for the people of this country is Medicare For All.

Not only is this country being hollowed out but your well-being is in jeopardy….and yet you prefer to see what moron has posted a cat video on Twitter or Instagram or whatever other mindless stupidity is out there.

Until the voter starts truly paying attention then we deserve all the silliness and mindless stupidity we get.

Turn The Page!

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Medicare Advantage

I try to be an FYI blog when I can…..

First let me say that I am not some old fart trying to sell you the idea that you cannot exist without spending more money to supplement your Medicare.

We see ad after ad these days telling us old farts just how much better life would be it we buying additional insurance policies.

What is ‘Medicare Advantage’?

Medicare Advantage, also known as Medicare Part C, makes it possible for people with Medicare Part A (hospital insurance) and Part B (medical insurance) to receive their Medicare benefits in an alternative way. Medicare Advantage plans are offered by private insurance companies contracted with Medicare and provide at least the same level of coverage that Medicare Part A and Part B provide.

Personally I think it is all marketing which means I think it is a scam…..and an end run to try and privatize Medicare totally….

Medicare Advantage is a massive, trillion-dollar rip-off, of the federal government and of taxpayers, and of many of the people buying the so-called Advantage plans.

It’s also one of the most effective ways that insurance companies could try to kill Medicare For All, since about a third of all people who think they’re on Medicare are actually on these privatized plans instead.

Nearly from its beginning, Medicare has allowed private companies to offer plans that essentially compete with it, but they were an obscure corner of the market and didn’t really take off until the Bush administration and Republicans in Congress rolled out the Medicare Modernization Act of 2003. This was the GOP’s (and a few corporatist Democrats’) big chance to finally privatize Medicare, albeit one bite at a time.

https://www.commondreams.org/views/2021/09/08/medicare-advantage-profit-scam-time-end-it

If you are retired and considering a Medicare Advantage policy please read this article and do some deep research before giving your cash away.

Here is a place to start…..https://www.ehealthmedicare.com/medicare-advantage-articles/what-are-the-pros-and-cons-of-switching-to-a-medicare-advantage-plan/

Please do not be taken in by promises of spending less….there is always hidden caveats….do the hard research before giving your hard fought retirement away.

Turn The Page!

I Read, I Write, You Know

“lego ergo scribo”

That Trump Drug Discount Card

The closer we get to the election the more blatant the tricks by the GOP and Trump are becoming to try and secure votes.

Our dear president has lied constantly to the seniors that are fighting high cost of drugs…..he went so far as to tell diabetics that he has made insulin cheap as water……https://lobotero.com/2020/10/02/cheap-like-water/

Apparently he has NEVER even bothered to look at the cost of insulin for diabetics……another cheap lie at election time.

Then his brilliant idea of a drug discount card for $200 for seniors……and that I have also written about……https://lobotero.com/2020/09/30/closing-thought-30sep20/

Another lie another cheap trick begging for votes.

But if you are a fiscal conserv you might ask just where will the money come from from this “discount card”?

Well in a typical Repub plan he plans to raid Medicare for the funds for his cheap trick…..

I then read an article about this intended plan….

Less than a month away from the November election, Trump administration officials are reportedly rushing to implement the president’s recent proposal to send $200 prescription drug discount cards to nearly 40 million Medicare recipients—an $8 billion plan that would be financed by dipping into the Medicare trust fund.

Politico reported Thursday that the administration is “seeking to finalize the plan as soon as Friday and send letters to 39 million Medicare beneficiaries next week, informing seniors of Trump’s new effort to lower their drug costs, although many seniors would not receive the actual cards until after the election.” While the design of the cards has yet to be finalized, officials are reportedly discussing ways to put Trump’s name on them.

The plan would cost $7.9 billion, according to Politico, with $19 million going toward letters touting the initiative, which advocacy groups and Democratic lawmakers are denouncing as an obvious and potentially unlawful campaign ploy that would provide little relief for the millions impacted by obscenely high drug prices.

https://www.commondreams.org/news/2020/10/09/shameless-stunt-trump-reportedly-attempting-raid-medicare-trust-fund-pay-drug

Like I stated earlier…a pathetic cheap trick in the search for votes.

But will Seniors see this worthless program for what it is?  A cheap trick and an attempt to help bankrupt Medicare.

Be Smart!

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VOTE!

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“lego ergo scribo”