{"id":89997,"date":"2025-07-25T00:30:10","date_gmt":"2025-07-25T00:30:10","guid":{"rendered":"https:\/\/www.europesays.com\/us\/89997\/"},"modified":"2025-07-25T00:30:10","modified_gmt":"2025-07-25T00:30:10","slug":"reforms-for-medicare-advantage-pondered-as-investigators-probe-unitedhealths-program","status":"publish","type":"post","link":"https:\/\/www.europesays.com\/us\/89997\/","title":{"rendered":"Reforms for Medicare Advantage pondered as investigators probe UnitedHealth&#8217;s program"},"content":{"rendered":"<p class=\"rt-Text\">\u201cThe challenge is: Anything you do to tighten up risk adjustment can have an impact on the benefits that people get,\u201d Chernew said. \u201cThe questions are: By how much, and which benefits are affected? Program integrity is an important goal, but I don\u2019t think anybody wants to destroy the Medicare Advantage program.\u201d<\/p>\n<p class=\"rt-Text\">UnitedHealth Group, which runs UnitedHealthcare, the nation\u2019s largest health insurer, has long defended the MA program and continues to do so.<\/p>\n<p class=\"rt-Text\">\u201cMA plans do a much better job of identifying and documenting health risks than traditional fee-for-service Medicare,\u201d the company said in a <a href=\"https:\/\/www.unitedhealthgroup.com\/newsroom\/2024\/2024-12-uhg-response-wsj-recent-reporting-medicare-advantage.html#\" target=\"_blank\" rel=\"nofollow noopener\" title=\"https:\/\/www.unitedhealthgroup.com\/newsroom\/2024\/2024-12-uhg-response-wsj-recent-reporting-medicare-advantage.html#\">December statement<\/a>. <\/p>\n<p class=\"rt-Text\">Insurers argue the large MA market share, which has built steadily over the past two decades, speaks to its popularity. It has been chosen by nearly 35 million seniors and individuals with disabilities nationwide, according to America\u2019s Health Insurance Plans (AHIP), the trade group for health insurance companies.<\/p>\n<p class=\"rt-Text\">At Tuesday\u2019s congressional hearing, Doggett quoted the viral video of a <a href=\"https:\/\/www.startribune.com\/as-alleged-ceo-killer-heads-to-court-unitedhealth-spars-with-surgeon-investor-in-coverage-dispute\/601226132\" target=\"_blank\" rel=\"nofollow noopener\" title=\"https:\/\/www.startribune.com\/as-alleged-ceo-killer-heads-to-court-unitedhealth-spars-with-surgeon-investor-in-coverage-dispute\/601226132\">Texas plastic surgeon<\/a> who said a patient was on the operating table when a message arrived from UnitedHealthcare with a question on coverage for the procedure.<\/p>\n<p class=\"rt-Text\">\u201cStories like hers are why I\u2019ve asked the Justice Department to expand its investigation into United,\u201d said Doggett.<\/p>\n","protected":false},"excerpt":{"rendered":"\u201cThe challenge is: Anything you do to tighten up risk adjustment can have an impact on the benefits&hellip;\n","protected":false},"author":3,"featured_media":89998,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[35],"tags":[210,1141,1142,67,132,68],"class_list":{"0":"post-89997","1":"post","2":"type-post","3":"status-publish","4":"format-standard","5":"has-post-thumbnail","7":"category-health-care","8":"tag-health","9":"tag-health-care","10":"tag-healthcare","11":"tag-united-states","12":"tag-unitedstates","13":"tag-us"},"share_on_mastodon":{"url":"https:\/\/pubeurope.com\/@us\/114911053334310956","error":""},"_links":{"self":[{"href":"https:\/\/www.europesays.com\/us\/wp-json\/wp\/v2\/posts\/89997","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.europesays.com\/us\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.europesays.com\/us\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.europesays.com\/us\/wp-json\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/www.europesays.com\/us\/wp-json\/wp\/v2\/comments?post=89997"}],"version-history":[{"count":0,"href":"https:\/\/www.europesays.com\/us\/wp-json\/wp\/v2\/posts\/89997\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.europesays.com\/us\/wp-json\/wp\/v2\/media\/89998"}],"wp:attachment":[{"href":"https:\/\/www.europesays.com\/us\/wp-json\/wp\/v2\/media?parent=89997"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.europesays.com\/us\/wp-json\/wp\/v2\/categories?post=89997"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.europesays.com\/us\/wp-json\/wp\/v2\/tags?post=89997"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}