Many seniors receive health insurance coverage through Medicare Advantage plans, a program that corporate insurers promised would promote efficiency and cost savings and strengthen Medicare. However, the facts show that certain corporate insurers use Medicare Advantage to drive up their profits at the expense of patient care while costing American taxpayers far more than traditional Medicare. This National Senior Citizens Day offers an opportunity to take a closer look at how insurers’ tactics hurt seniors and to discuss solutions to ensure seniors receive the care they deserve.
As many as 33 million adults over 65 are enrolled in Medicare Advantage plans today. However, it is increasingly well-documented that these plans have at times been promoted through misleading advertising and scam tactics. Older Americans are frequent targets of these practices and often report feeling trapped after falling for deceptive enrollment strategies.
Why do some corporate insurers promote Medicare Advantage plans so aggressively? Recent investigations by STAT News and the Wall Street Journal reveal how much some corporate insurance giants stand to gain by misusing the program to line their own pockets improperly.
An investigation by STAT News recently highlighted how UnitedHealth Group and other corporate insurers pressured thousands of clinicians to use an artery disease device that falsely diagnosed and subsequently falsely coded patients. This led tax-funded Medicare Advantage programs to pay billions of dollars to corporate insurers. UnitedHealth alone received $4 billion over just four years.
Insurers have also been caught conducting patient visits solely to add dubious diagnoses to patients’ Medicare records and collect additional payments from the federal government at taxpayers’ expense. A stunning Wall Street Journal investigation revealed that millions of screening visits between 2019 and 2021 led to unnecessary diagnoses, totaling $50 billion of Medicare payment revenue that corporate insurers wrongly captured. These diagnoses were encouraged to be added by some corporate insurers, not the doctors who prescribed them, and the alleged conditions subsequently went completely untreated by hospitals and doctors. While some corporate insurers engage in these cost-padding practices, UnitedHealth reportedly averaged three times more in extra Medicare payments than its competitors.
One featured patient, a 73-year-old who happened to be a neurologist herself, was shocked when she was diagnosed with peripheral artery disease by a faulty device pushed by corporate insurers. Her primary care doctor later confirmed that the diagnosis was likely inaccurate.
These practices are unacceptable. They represent huge, ultra-profitable corporations taking advantage of patients, hospitals, the government, and American taxpayers. While caregivers, providers, and hospital staff work tirelessly every day to prioritize patients ahead of profits, giant corporate insurers keep pioneering new ways to do just the opposite.
On this National Senior Citizens Day, we encourage lawmakers to rein in the Medicare Advantage system and to hold corporate insurers accountable for their improper and deceptive practices. Seniors deserve better, and Congress and policymakers must recognize and support hospitals as the heart of quality and accessible healthcare that they are. If these deceiving practices are allowed to continue, Congress will effectively be allowing the deterioration of quality patient care and the continued transfer of taxpayer dollars away from seniors’ medical care into corporate insurance companies’ deep pockets.