U.S. Finds Many Failures in Medicare Health Plans – NYTimes.com

imageInexcusable both on the part of insurers and Medicare administrators. You might want to check out your Medicare health plan or the one you may be considering this open enrollment. Read the full article for more details and some plan names.

WASHINGTON — Federal officials say they have repeatedly criticized, and in many cases penalized, Medicare health plans for serious deficiencies, including the improper rejection of claims for medical services and unjustified limits on coverage of prescription drugs.

The findings, cataloged in dozens of federal audit reports, come as millions of older Americans prepare to sign up for private health plans and prescription drug plans in Medicare’s annual open enrollment period, which will begin on Wednesday and continue through Dec. 7.

About 16 million people, accounting for 30 percent of the 54 million beneficiaries, are in private Medicare Advantage plans, which provide a full range of health care services under contract with the government. An additional 23 million people are in prescription drug plans, which cover only medications.

Federal officials expressed frustration that they were seeing the same kinds of deficiencies year after year. In a memorandum to health plans, Gerard J. Mulcahy, the Medicare official in charge of oversight and enforcement, listed common “areas of noncompliance” identified in program audits.

via U.S. Finds Many Failures in Medicare Health Plans – NYTimes.com.

5 comments

  1. To paraphrase the comment of General Worden (Ernest Borgnine) to Major Reisman (Lee Marvin) in the movie the ‘Dirty Dozen’…
    “NOW THAT’S A GOOD ARTICLE!!!”
    Very useful and sort of drives home the point that we geezers should look twice at our coverage, etc right now or we could pay a hefty out of pocket price later.
    [the original Dirty Dozen quote (for those who care) was “NOW THAT”S A GOOD QUESTION!!!”, said by Worden near the beginning of the film when Reisman was getting a briefing about the mission]
    NICE JOB Dick in finding it and posting it for everyone. Thank you and a I really mean that.

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  2. Factoid from the northwest: I work for a fairly large organization in King County in the State of Washington, where Seattle is located. The health insurance premiums for 2015 were provided to employees two weeks ago. An employee with spouse/partner and children will have their insurance premiums increase by 37% in 2015. In addition, the deductible has increased by about 40% as well.

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    1. With all due respect Mr. Ryan, this is an interesting factoid but how does it relate to the topic of “US Finds Many Failures In Medicare Health Plans?”…. It is interesting at any rate, “since most people vote their wallet” sort of makes you wonder how anyone could vote for a Democrat who had anything to do with or supports ObamaCare or would not pledge to vote to repeal it. Well never mind…”HAVE A NICE DAY!!!…or should I say “see you around, buddy”?

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