'Our Seniors Deserve Better': Jayapal Demands End of All Medicare Privatization Schemes [View all]

[douglas9]

The Congressional Progressive Caucus chair's call follows a report further detailing how Medicare Advantage plans overbill the federal government to boost profits.

Rep. Pramila Jayapal on Monday called for an end to all Medicare privatization schemes following a Washington Post report spotlighting how Medicare Advantage plans are distorting patients' medical records to overbill the federal government and boost their profits.

"Medicare Advantage plans regularly deny needed care to seniors and frequently create fake illnesses to defraud the government," Jayapal (D-Wash.), the chair of the Congressional Progressive Caucus, wrote in a social media post.

"This is a clear-cut example of why we must end Medicare privatization programs."

"This is a clear-cut example of why we must end Medicare privatization programs," added Jayapal, the lead sponsor of the Medicare for All Act in the House. "Our seniors deserve better."

Privately run Medicare Advantage (MA) plans have long been notorious for the practice of upcoding, whereby large insurers and other MA firms make enrollees appear sicker than they actually are in order to reap larger payments from the federal government—even as they refuse to provide necessary care for tens of thousands of patients each year.

The Post on Sunday detailed the case of Kathy Ormsby, a former employee of the Palo Alto Medical Foundation who blew the whistle on the firm's efforts—alongside its parent affiliate Sutter Health—to pressure doctors into adding false diagnoses to patients' medical histories.

"The point of larding the medical records with outdated and irrelevant diagnoses such as cancer and stroke—often without the knowledge of the patients themselves—was not providing better care, according to a lawsuit from the Justice Department, which investigated a whistleblower complaint Ormsby filed," the Post noted. "It was to make patients appear sicker than they were."


https://www.commondreams.org/news/2022/06/07/our-seniors-deserve-better-jayapal-demands-end-all-medicare-privatization-schemes