Corporate Insurers Take More Than $88 Billion In Medicare Overpayments While Denying Critical Care

January 13, 2024

Corporate Insurers Take More Than $88 Billion In Medicare Overpayments While Denying Critical Care

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In case you missed it, a new report uncovers how corporate insurance companies are banking record profits while being overpaid by the Medicare program by tens of billions of dollars. New findings released by the Medicare Payment Advisory Commission (MedPAC) reveal that the federal government “is projected to pay privately run Medicare Advantage plans $88 billion more in 2024 than it should,” POLITICO reports.

The new findings are the latest in a growing body of evidence that corporate insurers are pursuing record profits at the expense of patients – including by delaying and denying critical care.

FLASHBACK: 

  • DECEMBER 14, 2023: An investigation by NBC News found that the corporate insurance companies that charge the Medicare program to cover seniors “routinely reject claims for necessary care.
  • DECEMBER 28, 2023: Days later, a separate investigation by STAT revealed that “UnitedHealth Group used secret rules to restrict access to rehabilitation care requested by specific groups of seriously ill patients, including those who lived in nursing homes or suffered from cognitive impairment,” uncovering how “many patients enrolled in Medicare Advantage plans were routed for a quick denial based on criteria neither they, nor their doctors, were aware of.
    • Shedding light on the corporate insurer’s motivations for denying patients care, STAT explains that “UnitedHealth has more money than it knows what to do with” as the company reported profits of “more than $22 billion in 2023. That was up more than 11% year over year.”
    • At the same time, UnitedHealth alone controls approximately 10 percent of all physicians in America, totaling 90,000 employed and affiliated physicians – part of a larger trend of corporate insurers are buying up physician practices to exert even more control over Americans’ care.
  • NOVEMBER 24, 2023: A growing, bipartisan chorus of lawmakers speaks out about the abusive practices of certain commercial insurance companies, including denials and delays to care.

It’s no surprise that a recent poll also reveals that voters are concerned about corporate insurers’ role in driving higher healthcare costs and delaying and denying patients’ care. Yet today, these same corporate insurance companies and other powerful special interests are lobbying Congress to enact harmful Medicare cuts to hospital care that would put patients at risk and threaten access to crucial services that only hospitals provide.

Lawmakers must reject these harmful Medicare cuts to hospital care and instead hold corporate insurance companies accountable for  abusive practices that are costing taxpayers billions while denying important care for patients.

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