Elevance Health sues feds over ‘arbitrary and capricious’ star ratings for Medicare Advantage plans

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2 thoughts on “Elevance Health sues feds over ‘arbitrary and capricious’ star ratings for Medicare Advantage plans

  1. If the calculation is no transparent or repeatable, I can see a problem. As for the rounding, that sounded like it was easy to explain and I don’t think they have a leg to stand on.

    There is a simple solution, offer better plans. BUT, my financial advisor strongly warned DO NOT ENROLL in any Medicare Advantage Plan. The often have hidden lifetime caps that are much lower than traditional Medicare. He also said to look closely about what is considered in-network. I’d hate to retire and then somebody tell me I can’t head to Florida or Arizona for the winter because “it’s out of network”!

  2. As Rep. Jan Schakowsky and Wendell Potter recently wrote in Newsweek, “Where billions of dollars flow, deceptive actors follow. And nowhere does deception run deeper than how health insurers lure seniors into Medicare Advantage plans—only to leave many retirees struggling to cover their out-of-pocket requirements when their incomes are their lowest.

    “Now that we are in the middle of the annual enrollment period for 2023 Medicare Advantage plans, we can’t turn on the TV or, if we’re seniors, open the mailbox without seeing the ads and flyers. “Free” health insurance. “Zero co-pay” plans and “add money back into your Social Security check!” To fixed income seniors, these offerings sound like a godsend, especially when some of America’s well-known actors are delivering the message. And insurers’ printed materials are often designed to look as if they came from the U.S. government.

    “Unfortunately, these plan offerings can quickly turn into a nightmare.

    “Medicare Advantage is a health insurance program in which private health insurers are reimbursed generously by the federal government for providing insurance coverage, sometimes with additional benefits, to retired Americans. This incentivizes insurers to sign up as many elderly folks as they can. While many Medicare Advantage plans provide some coverage for dental, vision and hearing and discounts on gym memberships, their ads obscure the often-life-threatening restrictions and bank-account draining demands that are common in Medicare Advantage plans.

    “One thing is for sure: Seniors deserve comprehensive health care, not to be bombarded and scammed. Insurers are not hurting for money, least of all to market their Medicare Advantage plans. They all reported record profits in 2021, during a global pandemic. It is long past time for Congress and CMS to clean up what has become many insurers’ biggest cash cow.”

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