More in GOP looking to rein in MA plans.
- Joe Russell
- Apr 23
- 1 min read
As the Republican led Congress continues to look for ways to slash spending, more eye are turning to Medicare Advantage. Our team has seen this evolve on Capitol Hill over the past several years. Now, there seems to be growing momentum. For example, Sen. Bill Cassidy (R-LA) has teamed up with Sen. Ron Wyden (D-OR) are writing the No UPCODE Act to stop the perceived gaming by insurers. Read more here.
MA plans were able to garner more than $33 billion in extra payments in 2021 by using billing codes that portrayed members as unhealthy to generate additional revenue. According to a study published in the Annals of Internal Medicine last week, coding differences in 2021 helped push the average MA enrollee's risk score 18.5 percent higher than the enrollee average for traditional Medicare. UnitedHealthcare profited the most from its "coding intensity" strategy, collecting $13.9 billion, followed by Humana with $6.3 billion, Elevance Health with $2.1 billion, CVS Health with $2 billion and Kaiser Permanente with $500 million. To view the study, click here. Click here for a detailed media report.
MA stocks are up after the big payment increase announcement last week. Here's a brief media explainer on why MA got the increase.
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