Nevada's Rosen opposes changes to Medicare Advantage funding formula
Mar. 30—U.S. Sen.
Rosen, D-
"As you know, MA (Medicare Advantage) is an important and popular program that provides quality, affordable health coverage to over 28 million Americans, including more than half of all Medicare beneficiaries in
Last week, the New York Times reported the Biden administration was seeking to change the payment formula in an effort to crack down on alleged widespread fraud within the Medicare Advantage program. Medicare Advantage is a health plan offered by private companies that contract with Medicare to include coverage for hospital stays, doctors visits and other benefits.
The Biden administration has proposed eliminating roughly 2,000 diagnosis codes from the funding formula, including for mild depression, vascular disease and diabetes with complications, according to the
The administration says it has increased funding overall for the program by 9.5% over the past few years, and the reform is necessary to shore up the
Rosen said Nevadans depend on Medicare Advantage for their zero-dollar premiums and comprehensive coverage of dental, hearing and vision care — especially those living in rural areas.
"For example, in
"In particular, I have heard concerns from providers and stakeholders that the proposed changes to diagnosis codes could negatively impact the care delivered to
In January,
The questionable payments are submitted through Medicare Advantage, a booming program that nearly half of the 60 million people enrolled in Medicare sign up for. The government spent
With the rise in popularity has come growing concern that insurers are ripping off taxpayers by overstating how sick a patient is to unlock higher reimbursements from the government.
It's unclear when the proposed changes could go into effect, but a final say could be coming within days if not weeks, the
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