Medicare Advantage within the headlines: 7 recent developments


From CMS increasing its oversight on celebrity sales pitches to the advancing of a previous authorization reform bill, listed below are seven Medicare Advantage stories Becker’s has reported since July 20:

1. CMS has toughened its oversight on celebrity Medicare Advantage sales pitches following a surge of complaints last yr, The Wall Street Journal reported Aug. 31. 

2. Medicare Advantage plans are expected to make up half of all Medicare enrollment by 2026, with the national average currently at 45.5 percent. Some states, nonetheless, are lagging behind the remaining of the country. Becker’s spoke with three payers in a few of the states with the bottom enrollments to see what direction they’re going with Medicare Advantage plans. 

3. UnitedHealthcare and Humana account for 46 percent of the 28.4 million people enrolled in Medicare Advantage plans in 2022, in keeping with the Kaiser Family Foundation. 

4. Senate Finance Committee Chairman Ron Wyden launched a probe into potentially deceptive marketing tactics utilized by Medicare Advantage plans. Mr. Wyden sent letters to fifteen state insurance commissioners and state medical health insurance  assistance programs on Aug. 18 requesting data regarding Medicare Advantage complaints and other information.

5. Overall member satisfaction with Medicare Advantage plans has risen steadily over the past few years, but most members say their plan doesn’t provide enough coverage for mental and behavioral services, in keeping with J.D. Power’s 2022 U.S. Medicare Advantage study published Aug. 18.

6. The House Committee on Ways and Means on July 27 advanced a bill to reform the Medicare Advantage prior authorization process. The bill is predicted to go before the total House for a vote this fall. 

7. The Higher Medicare Alliance released its 2022 “State of Medicare Advantage Report” on July 20, and it included a rating of states by Medicare Advantage enrollment as a percentage of overall Medicare enrollment.


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