Private Medicare Advantage carriers are acting like it’s 1950. The age of bad faith is on display in regard to people who need medical care the most.
Private Medicare Advantage insurance companies are denying clearly covered Medicare claims and imposing caps on seniors filling their prescriptions when the caps have no basis other than the carriers’ power to impose prescription caps and deny claims of sick older people.
These findings are “cataloged in dozens of federal audit reports”. Federal officials report “the same kind of deficiencies year after year.” The findings and the Federal officials are from the Centers for Medicare and Medicaid Services. About the only thing that seems to stop the bad faith abuse by private insurance companies under contract for Medicare Advantage coverage of the elderly is for the Federal government to refuse to allow the offending private insurance carriers to sign up any more patients at Federal Taxpayer expense. See Robert Pear, “U.S. Finds Many Failures in Medicare Health Plans” p. A14, col. 5 (New York Times Nat’l ed., Monday, October 13, 2014).
Waste no time on tears for the Medicare Advantage companies. They do not contest the charges. Id.
What do they say if anything in response to these findings? “Insurers usually do not dispute the audit findings, but say the care they provide is superior to that in the traditional fee-for-service Medicare program.” Robert Pear, New York Times, supra.
The catch is that it seems they actually do not provide enough care when they do pay for it.
Apparently paying claims is against their business model.
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