'These companies have built entire businesses around making beneficiaries look as sick as possible,' said SenWarren. 'And unsurprisingly, government watchdogs have discovered widespread abuse.'
of beneficiaries and potentially impact the quality of care—but experts, advocates, and progressive lawmakers are pushing back. defended the administration's proposals against Medicare Advantage industry"scare tactics" and argued that"these companies have built entire businesses around making beneficiaries look as sick as possible.
"The more diagnosis codes that a beneficiary has, the higher the payment, and whatever insurers don't spend on care they actually get to keep," Warren said."Unsurprisingly, government watchdogs have discovered widespread abuse."late last year that government audits have uncovered"widespread overcharges and other errors in payments to Medicare Advantage health plans, with some plans overbilling the government more than $1,000 per patient a year on average.
Advocacy organizations—including groups representing physicians, nurses, and seniors—have attempted to counter the torrent of industry-backed criticism of the Biden administration's proposals via the public comment process. "The proposed reforms resulting in a limit of 1% increase is still an increase, which we understand is being opposed by the [Medicare Advantage] industry and their associations, and being mischaracterized as a cut. It is a cut only as far as it doesn't replicate the huge 8% increase granted last year,"
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