Jan 27 2012
Insurers offering Medicare Advantage plans were overpaid by as much as $3.1 billion in 2010 because the government miscalculated how sick beneficiaries were, according to a review by the Government Accountability Office that was made public by congressional Democrats.
Modern Healthcare: Adjust Advantage Plan Pay Rates Even Further: GAO
The CMS needs to further adjust pay rates for Medicare Advantage plans, according to a government report, to more accurately reflect their beneficiaries' health and to avoid overpaying for the care of patients who are not as ill as the insurers claim. The report by the Government Accountability Office, made public by congressional Democrats, reviewed a pay adjustment established in recent years to overhaul the rate Medicare pays the private insurers that cover about a quarter of the program's beneficiaries (Daly, 1/26).
CQ HealthBeat: GAO Urges CMS to Change Calculation of Private Plan Payments
The Medicare program uses a flawed methodology to pay private health plans that led federal officials to overpay insurers by $1.2 billion to $3.1 billion in 2010, according to a study released Thursday by the Government Accountability Office. GAO analysts urged Medicare officials to change the methodology for these private health plans, known as Medicare Advantage (MA). And House Democrats, who requested the report, pounced on the news as further evidence that Medicare is paying private plans too much (Adams, 1/26).
Bloomberg: Medicare Overpaid Insurers $3.1 Billion In 2010 On U.S. Errors
Insurers offering Medicare health plans were overpaid by the U.S. as much as $3.1 billion in 2010 because the government miscalculated how sick beneficiaries were, federal auditors said. UnitedHealth Group Inc. (UNH) of Minnetonka, Minnesota, and Humana Inc. (HUM) of Louisville, Kentucky, are among the insurers offering coverage to people 65 and older through Medicare Advantage, an alternative to the traditional federal health program for the elderly and disabled. Democrats have criticized Medicare for overpaying companies for Advantage plans and the 2010 health-care overhaul reduced payments about $136 billion through 2019 (Wayne, 1/27).
 This article was reprinted from kaiserhealthnews.org with permission from the Henry J. Kaiser Family Foundation. Kaiser Health News, an editorially independent news service, is a program of the Kaiser Family Foundation, a nonpartisan health care policy research organization unaffiliated with Kaiser Permanente.
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