Here are seven updates about Medicare Advantage Becker’s has reported since June 8.
- New York City Mayor Eric Adams is overriding the city comptroller’s attempt to block the implementation of its contract with Aetna to administer a Medicare Advantage plan for 250,000 city retirees. City Comptroller Brad Lander sought to block the implementation of the contract while a lawsuit from retirees challenging the plan is ongoing.
- The Alliance of Community Health Plans proposed a set of policies aimed at curbing misleading marketing in Medicare Advantage.
- Aetna is seeking to intervene in a lawsuit filed by retired New York City employees seeking to block the payer’s Medicare Advantage contract with the city from taking effect. In a petition, the company denied allegations from the retirees that Aetna’s Medicare Advantage plan could subject retirees to coverage denials, higher out-of-pocket costs and more restrictive networks.
- Medicare Advantage plan enrollees have lower expenses than those with similar risk scores who remain in traditional Medicare, but payments to the program are based on traditional Medicare, according to a whitepaper from researchers at the University of Southern California in Los Angeles. The analysis suggests Medicare Advantage overpayments could be higher than previously thought.
- Independence Blue Cross’ Keystone Health Plan East received an estimated $11.3 million in overpayments for 2016 and 2017, according to an audit from HHS’ Office of Inspector General.
- Audits published in the last six months found almost $32 million in overpayments across six Medicare Advantage plans, according to the OIG’s semiannual report to Congress.
- Medicare Advantage patients who receive in-home health visits through the Optum HouseCalls program spend less time in the emergency room and inpatient hospital settings, according to a study by Yale Medicine and Optum researchers.
