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Bettie

(19,176 posts)

2. They get paid to avoid providing care

Reply to marmar (Original post)

Thu Dec 4, 2025, 10:07 AM

13 hrs ago

From the article: "The companies get paid based on how much money they save Medicare by denying approvals for “unnecessary or non-covered services,” CMS said in a statement unveiling the program."

Sounds like those Death Panels the right wing was so alarmed about...weird how okay they are with it when it's their guys setting them up.

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9 members have recommended this reply (displayed in chronological order):

markodochartaigh area51 NotHardly iluvtennis Joinfortmill SergeStorms SunSeeker not fooled duckworth969

27 replies

= new reply since forum marked as read

Highlight:

Medicare's new AI experiment sparks alarm among doctors, lawmakers [View all] marmar 13 hrs ago OP

Kick dalton99a 13 hrs ago #1

They get paid to avoid providing care Bettie 13 hrs ago #2

Isn't it, though! (n/t) OldBaldy1701E 11 hrs ago #5

Traditional WmChris 13 hrs ago #3

Kicking with DISGUST!!!! Faux pas 12 hrs ago #4

One Goal Is Likely To Deny Coverage For Diabetes 2 And Its Related... ColoringFool 11 hrs ago #6

Jeezus. Joinfortmill 11 hrs ago #8

Any use of AI in a customer service context is to be feared. "Speak to a representative" is my answer to what I want to Martin68 11 hrs ago #7

AI learns that there's a reward for denying coverage. SergeStorms 11 hrs ago #12

AI finds it more cost efficient to let us die faster IronLionZion 9 hrs ago #19

there is help for patients Nigrum Cattus 11 hrs ago #9

Could you please elaborate for those of us who are not inclined to readily click links? mahina 10 hrs ago #13

Wow! Thanks Nigrum Cattus! That's a great source for fighting insurance denials! BComplex 10 hrs ago #16

The problem isn't the availability of an appeal - Ms. Toad 8 hrs ago #20

Arizona is a swing state with lots of retirees IronLionZion 11 hrs ago #10

They will likely never hear about it, or understand it was REPUBLICANS who passed this BComplex 10 hrs ago #17

If they are looking for fraud and corruption instead popsdenver 11 hrs ago #11

They want us dead orangecrush 10 hrs ago #14

Who in the F*** authorized this change?? BComplex 10 hrs ago #15

Medicare has used private contractors to review claims since at least 1980. The pilot program is limited to 6 states Silent Type 10 hrs ago #18

Requiring conservative therapy is a Medicare Advantage/Insurance concept - it has no place in Standard Medicare Ms. Toad 7 hrs ago #21

Absolutly incorrect. Original Medicare has extensive coverage policies. No, the patient won't pay because it'll be Silent Type 7 hrs ago #22

Gotcha. You believe it is appropriate to force me to choose between Ms. Toad 17 min ago #25

How many of those services have anything to do with diagnosing or managing cancer? Plus, Silent Type 8 min ago #26

Trump's government... LudwigPastorius 7 hrs ago #23

It's bad enough when some employee at an insurance company who is not a doctor IcyPeas 7 hrs ago #24

I love the name - WISeR. It's become a cliche to say that every pronouncement by this administration is Orwellian jls4561 2 min ago #27