Medicare Advantage in the headlines: 9 recent updates

Medicare Advantage plans have faced scrutiny for possible upcoding and pressure to update provider directories. Here are nine Medicare Advantage updates Becker’s has reported since. Nov. 18. 

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By: Rylee Wilson
  1. The HHS’ Inspector General’s Office released audits of nine Medicare Advantage plans over the last six months, according to the organization’s semiannual report to Congress. The audits found more than $72 million in total overpayments among all the plans. 
  2. The Senate Finance Committee wants Medicare Advantage plans to create more accurate provider directories, according to a discussion draft with policies aimed at improving parity between physical and mental health services in Medicare and Medicaid. 
  3. More employers who offer retirees health benefits are choosing Medicare Advantage plans. In 2022, half of employers with retiree benefits offer Medicare Advantage, up from 26 percent in 2017. 
  4. Humana boosted its Medicare Advantage member predictions, expecting 100,000 more Medicare Advantage members in 2023 than it originally projected. 
  5. Newly released audits show Medicare Advantage plans overbilled the federal government by millions between 2011 and 2013, with some plans overbilling an average of more than $1,000 per patient per year. CMS released the decade-old audits in response to a lawsuit from Kaiser Health News. AHIP pushed back on the report, saying the reporting on the audits lacked context. 
  6. A pair of senators introduced a bill to improve the “Medicare & You” handbook after hearing complaints about seniors inadvertently selecting plans that do not best meet their healthcare needs. 
  7. For the first time in four years, MA average premiums have increased and currently sit at $7 per month for plans selected for 2023, according to a report from eHealth. 
  8. Almost every Medicare Advantage plan offers vision, hearing, dental and fitness benefits, but other services vary widely between plans. Here’s how payers stack up on nutrition and over-the-counter benefits.
  9. Lawton, Okla., has the least competitive Medicare Advantage market in the country, according to a study from the American Medical Association published Nov. 1. Canton-Massillon, Ohio, has the most competitive market.
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