Medicare Advantage isn’t living up to its promise, Former U.S. Rep. Jim Greenwood wrote in an op-ed published in The Hill June 15.
Mr. Greenwood was one of the authors of the Medicare Modernization Act of 2003, which created the Medicare Advantage program.
A system designed to deliver efficiency and value has “evolved into a system dominated by a handful of massive insurers who are gaming the rules for profit,” Mr. Greenwood wrote.
“It pains me to say this, but the system we helped create is being abused,” Mr. Greenwood wrote.
Mr. Greenwood wrote he still believes “private-sector participation can play a meaningful role in Medicare.” However, the current MA program needs reforms, he wrote, including more rigorous auditing and cracking down on upcoding.
In May, CMS said it would ramp up audits of Medicare Advantage plans, planning to audit each plan for diagnosis coding accuracy every year. Lawmakers have also introduced legislation aimed at cracking down on upcoding in the program.
Read the full op-ed here.
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