Thursday, June 5, 2014

GOP's Medicare Advantage has wasted $70 billion and counting in improper payments due to flaw.

Under Bush, when Republicans decided to spend money like drunken sailors on the credit card, they created and passed the highly flawed and unpaid for Medicare Advantage Part D Program. It was an attempt to privatize the program. It currently cost 14 percent more than similar services for regular Medicare, and surprise, left a huge hole in it for massive overcharging; to the tune of $70 billion. That number might be bigger.

And they have the balls to complain about the Affordable Care Act?
WaPo: For the past two years, the Obama administration has backed down from making steeper cuts to the Medicare Advantage program Obamacare is supposed to cut the Medicare Advantage program by $156 billion over a decade to reduce the bloated program serving about 16 million seniors. Insurers as of 2009 had been reimbursed 14 cents more on the dollar for Medicare Advantage beneficiaries compared to seniors in the traditional program, and the Affordable Care Act is supposed to close that gap.

Now, a new investigation from the Center for Public Integrity finds that insurers have been taking in much more money than they should have from the $150 billion-a-year program. Between 2007 and 2011, insurers netted $70 billion in improper payments from a program design flaw, according to the center's review of enrollment data, government audits, research papers and other documents.

CPI's report describes how insurers are bringing in the extra payments through Medicare Advantage's "risk scoring" system, which pays insurers higher rates for patients in worse health. It's been known for a while that insurers have been benefiting from the risk scoring system — essentially reporting that patients are sicker than they actually are — but CPI's investigation finds the problem is much larger than previously described.


  1. You're sure pretty ignorant about Medicare. The program now called Medicare Advantage has been around for over 40 years and it was formalized into law under President Clinton (based substantially on a proposal from the left-wing Urban Institute by a guy who is now President Obama's designee as Medicare trustee). There is no "attempt to privatize the program." Public Part C Medicare Advantage is a public option to Original Medicare, particularly providing the poor and minorities -- who use it disproportionately to Original Medicare -- a way to avoid the high cost of private Medicare supplements (known as Medigap plans). It currently "costs 3% more" (that's an inaccurate way to say it but so is the rest of your blog), not 14% more. The $70 billion claim by the lefty Center for Integrity appears to be a complete fiction based on GAO and HHS/ASCE reports (but we can't be sure because the Center for Integrity hasn't explained its methodology)

  2. Thanks for the input. In a way, you're right. I completely left of "Part D" in my opening sentence. Now try to defend yourself? The Bush Medicare Modernization Act added Part D. All the other information provide in the story factual. You might want to bash a "lefty" organization, but their analysis is accurate. Lefty, righty, if the facts are accurate, it doesn't matter, right?

    Same old excuse to; what was their methodology, as if that proves they're wrong. Like you have a more accurate one? The ploy is getting very old.