Bill would ban payers from selling Medicare Advantage plans under Medicare name

Two U.S. representatives have introduced a bill that would rename Medicare Advantage plans, prohibit private insurers from using "Medicare" in plan titles or advertisements and impose "significant fines for any insurer that engages in this deceptive practice."

Rep. Mark Pocan, one of the bill's two Democratic sponsors, said Medicare Advantage programs provide "pale alternatives to what Medicare does" and undermine traditional Medicare. 

"They often leave patients without the benefits they need while overcharging the federal government for corporate profit," Mr. Pocan said in an Oct. 13 news release emailed to Becker's. "This bill eliminates any confusion about what is — and what is not — Medicare, and ensures this essential program will continue to serve seniors and other Americans for years to come."

The bill comes after The New York Times reported Oct. 8 that federal audits show that eight of the 10 biggest Medicare Advantage insurers have submitted inflated bills. Four of the five largest Medicare Advantage insurers — UnitedHealth, Humana, Elevance and Kaiser — have faced federal lawsuits alleging efforts to overdiagnose their customers "crossed the line into fraud."   

Mr. Pocan and fellow sponsor Rep. Ro Khanna also pointed to a Medicare Payment Advisory Commission report from March that said Medicare Advantage plans received $12 billion in excess payments in 2020. The report said Medicare Advantage risk scores were nearly 10 percent higher than similar fee-for-service enrollees in 2020 due to higher diagnosis coding intensity. '

The Better Medicare Alliance, a national Medicare Advantage research and advocacy group, pushed back on the proposal, saying the healthcare choices of the 29 million Medicare Advantage beneficiaries "deserve respect and support in Washington." 

Better Medicare Alliance President and CEO Mary Beth Donahue said in an Oct. 14 statement shared with Becker's that Medicare Advantage plan beneficiaries give the program a 94 percent satisfaction rate and save nearly $2,000 per year compared to traditional fee-for-service Medicare. She also said that in 2021, more than 80 percent of U.S. representatives signed a letter declaring support for seniors' Medicare Advantage coverage.       

Read the text of the legislation here

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