Dr. Kronick, a former deputy assistant secretary for health policy at HHS and a former consultant to CMS, was cited in an Oct. 8 New York Times investigation that analyzed how payers can raise profits by billions by making Medicare Advantage patients appear sicker than they are.
The real scandal, Dr. Kronick wrote in a letter responding to the investigation, is the behavior of the government, not Medicare Advantage plans.
CMS has an obligation to create a diagnostic coding system that accounts for rampant differences between Medicare Advantage and traditional Medicare, Dr. Kronick said.
“For the most part, Medicare Advantage plans are behaving as we would expect. It is our public servants who are letting us down,” Dr. Kronick said.
