Medicare Advantage (MA) plans — once touted as a cost-effective alternative to traditional Medicare — are bleeding taxpayers for billions of dollars more than traditional Medicare, denying medically necessary care and enriching private insurers at the expense of older Americans.

New data reveals these problems are widespread and growing, and Congress must act now to protect traditional Medicare and the millions of older Americans who depend on it.

Across the country MA plans now cover more than half of all Medicare beneficiaries. But they are ripping off taxpayers by exaggerating patient diagnoses (“upcoding”) to secure billions in extra payments — even after recent reforms. This “gaming of the system” bloats federal spending and weakens Medicare’s financial health.

What’s worse:

• MA plans routinely impose prior authorizations barriers for care that traditional Medicare covers automatically. Nursing home care and other essential services are often denied or delayed, harming vulnerable seniors with nowhere else to turn.
  

• Investigations show major insurers have turned risk adjustment into a profit center, exploiting coding rules rather than improving patient care.
  

• MA plans cost significantly more per beneficiary than traditional Medicare, with much of that extra spending tied to coding abuse and inflated payments.
  

Even though MA plans often fall short on quality, transparency and actual savings, the Trump Administration has aggressively expanded Medicare Advantage. And oversight by the Centers for Medicare and Medicaid (CMS), now led by Dr. Mehmet Oz, has failed to curb widespread abusive practices.

That’s why I’m asking you to sign the National Committee’s petition urging Congress to conduct oversight of CMS and Medicare Advantage plans, crackdown on unscrupulous MA insurers that deny medically necessary care and strengthen enforcement tools and penalties to ban abusive ‘health risk assessments’ and ensure accurate, honest reporting of patient diagnoses.

Medicare was designed to deliver high quality, affordable care to older Americans, not subsidize huge profits for private insurers. And traditional Medicare remains the most reliable way to ensure care is delivered based on medical need, not corporate incentives.

Please sign our urgent Petition to Congress today to demand real accountability and protection for Medicare!

Sincerely,

Max Richtman

President & CEO