Health insurers are ready to sue the government if Biden officials don’t let
them keep years of overpayments from Medicare.
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Insurers Are Fighting To Protect Their Medicare
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By The Lever – 13 Jan 2023 – View online
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In today’s featured
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below, The Lever’s Andrew Perez covers how health insurers are ready to sue
the government if Biden officials don’t let them keep years of overpayments
from Medicare.
Also: If you missed yesterday’s special Callin show for paid subscribers, like
yourself, you can click here to listen to the
recording<https://na01.safelinks.protection.outlook.com/?url=https%3A%2F%2Fwww.levernews.com%2Fr%2F3b0fbca8%3Fm%3D97cf581e-3056-4108-ad27-b428d8380853&data=05%7C01%7C%7C21d2e86f170a4f9d3cdf08daf568cdf2%7C84df9e7fe9f640afb435aaaaaaaaaaaa%7C1%7C0%7C638092127744337387%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C3000%7C%7C%7C&sdata=Haket187G3ZBTNU0MhejdqKgl1is9uQd%2BqFnkUcAgHg%3D&reserved=0>.
We had a great conversation about the stories we already see developing in
2023.
Rock the boat.
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By Andrew
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This year, for the first time, a majority of seniors eligible for Medicare will
be on privatized Medicare Advantage plans. Now, the insurance companies raking
in giant profits from these for-profit plans are mounting a pressure campaign
and planning to sue the government to protect years of overpayments they’ve
extracted from Medicare.
A cash cow for big
insurers<https://na01.safelinks.protection.outlook.com/?url=https%3A%2F%2Fwww.levernews.com%2Fr%2F5bfb3e97%3Fm%3D97cf581e-3056-4108-ad27-b428d8380853&data=05%7C01%7C%7C21d2e86f170a4f9d3cdf08daf568cdf2%7C84df9e7fe9f640afb435aaaaaaaaaaaa%7C1%7C0%7C638092127744337387%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C3000%7C%7C%7C&sdata=nWUGc6LZR2NBORprVVjgKjLIqaLPX3Z9%2BAno2D6bkEY%3D&reserved=0>,
the for-profit version of Medicare has not been a great deal for the American
public. Medicare Advantage plans cost the government more per
beneficiary<https://na01.safelinks.protection.outlook.com/?url=https%3A%2F%2Fwww.levernews.com%2Fr%2F386ad772%3Fm%3D97cf581e-3056-4108-ad27-b428d8380853&data=05%7C01%7C%7C21d2e86f170a4f9d3cdf08daf568cdf2%7C84df9e7fe9f640afb435aaaaaaaaaaaa%7C1%7C0%7C638092127744337387%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C3000%7C%7C%7C&sdata=%2FnDEBwPImHJ4q92clYI6s8eRMyiY4jsYcHsX4h4vpZc%3D&reserved=0>
than traditional Medicare, and often
wrongfully<https://na01.safelinks.protection.outlook.com/?url=https%3A%2F%2Fwww.levernews.com%2Fr%2F65701fa0%3Fm%3D97cf581e-3056-4108-ad27-b428d8380853&data=05%7C01%7C%7C21d2e86f170a4f9d3cdf08daf568cdf2%7C84df9e7fe9f640afb435aaaaaaaaaaaa%7C1%7C0%7C638092127744337387%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C3000%7C%7C%7C&sdata=g5Yz1ZywM94aNEf3G8jHuCPxNNIT7bNFMV4bulKtVXw%3D&reserved=0>
deny
care<https://na01.safelinks.protection.outlook.com/?url=https%3A%2F%2Fwww.levernews.com%2Fr%2F65a4cd40%3Fm%3D97cf581e-3056-4108-ad27-b428d8380853&data=05%7C01%7C%7C21d2e86f170a4f9d3cdf08daf568cdf2%7C84df9e7fe9f640afb435aaaaaaaaaaaa%7C1%7C0%7C638092127744337387%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C3000%7C%7C%7C&sdata=MgiyjtfskXR1JA3EbA3BrjYH6hCyBhWRerGBcAViSgA%3D&reserved=0>.
What’s more, federal audits have found Medicare Advantage plans systematically
overbilling<https://na01.safelinks.protection.outlook.com/?url=https%3A%2F%2Fwww.levernews.com%2Fr%2F17af8246%3Fm%3D97cf581e-3056-4108-ad27-b428d8380853&data=05%7C01%7C%7C21d2e86f170a4f9d3cdf08daf568cdf2%7C84df9e7fe9f640afb435aaaaaaaaaaaa%7C1%7C0%7C638092127744337387%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C3000%7C%7C%7C&sdata=PvRxCynLPnZA%2BWsON7b2CGVJAUgubEtvEDUpcl6Qn4g%3D&reserved=0>
the
public<https://na01.safelinks.protection.outlook.com/?url=https%3A%2F%2Fwww.levernews.com%2Fr%2Fec4f7e12%3Fm%3D97cf581e-3056-4108-ad27-b428d8380853&data=05%7C01%7C%7C21d2e86f170a4f9d3cdf08daf568cdf2%7C84df9e7fe9f640afb435aaaaaaaaaaaa%7C1%7C0%7C638092127744337387%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C3000%7C%7C%7C&sdata=%2FOj4g4eZyfWjoUHYJN68KI2mH3%2Brxha0kjb%2BU6H6LB4%3D&reserved=0>
— mostly by billing as if patients are sicker than they really are, a scheme
known as “upcoding.” Officials
estimate<https://na01.safelinks.protection.outlook.com/?url=https%3A%2F%2Fwww.levernews.com%2Fr%2F9b5009bf%3Fm%3D97cf581e-3056-4108-ad27-b428d8380853&data=05%7C01%7C%7C21d2e86f170a4f9d3cdf08daf568cdf2%7C84df9e7fe9f640afb435aaaaaaaaaaaa%7C1%7C0%7C638092127744337387%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C3000%7C%7C%7C&sdata=HAfogkcWYaKNU%2FwDRtKBXin7U4CCkhG0cr%2FOx%2F5nkT0%3D&reserved=0>
the private plans collected $650 million in overpayments from 2011 to 2013.
Tip
Jar<https://na01.safelinks.protection.outlook.com/?url=https%3A%2F%2Fwww.levernews.com%2Fr%2F31da3c64%3Fm%3D97cf581e-3056-4108-ad27-b428d8380853&data=05%7C01%7C%7C21d2e86f170a4f9d3cdf08daf568cdf2%7C84df9e7fe9f640afb435aaaaaaaaaaaa%7C1%7C0%7C638092127744493603%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C3000%7C%7C%7C&sdata=LhT9CLc7eYle%2BwTeNklrC8bOWI7OtROARdADQsBT9%2FI%3D&reserved=0>
The Biden administration is expected to finalize a rule next month to try to
recoup some of these overpayments — but Medicare Advantage insurers are
threatening to sue if the rule moves forward as written, according to Stat
News<https://na01.safelinks.protection.outlook.com/?url=https%3A%2F%2Fwww.levernews.com%2Fr%2Fa3b8ba21%3Fm%3D97cf581e-3056-4108-ad27-b428d8380853&data=05%7C01%7C%7C21d2e86f170a4f9d3cdf08daf568cdf2%7C84df9e7fe9f640afb435aaaaaaaaaaaa%7C1%7C0%7C638092127744493603%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C3000%7C%7C%7C&sdata=rHMyuOshkpXBeqFc2FHp9Kd9Q7T6qoDXbi1OCK%2BYNmU%3D&reserved=0>.
If insurers sue, it could further delay the government’s efforts to claw back
excess payments stretching back more than a decade, as well as future
overpayments.
The health insurance industry argues that regulators should allow for some
level<https://na01.safelinks.protection.outlook.com/?url=https%3A%2F%2Fwww.levernews.com%2Fr%2F305e93d7%3Fm%3D97cf581e-3056-4108-ad27-b428d8380853&data=05%7C01%7C%7C21d2e86f170a4f9d3cdf08daf568cdf2%7C84df9e7fe9f640afb435aaaaaaaaaaaa%7C1%7C0%7C638092127744493603%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C3000%7C%7C%7C&sdata=8JEt4JMDHaLz91uQwB4UVaLNc4VspLSkqapFYDWg6HU%3D&reserved=0>
of payment errors — and should only apply new rules to audits moving forward,
instead of retroactively punishing past misconduct.
“It’s crazy,” said Diane Archer, founder of Just Care USA, an organization that
opposes Medicare privatization. “They overcharged. Who’s ever heard of a
situation where you’re overcharged and you don’t get your money back? It’s
beyond comprehension. The Medicare trust fund should not be paying out funds
inappropriately, and it’s driving up Medicare [insurance] premiums.”
“Hundreds Of Millions Of Dollars, If Not More, At Stake”
President Joe Biden is doing nothing to slow the Medicare privatization push.
Indeed, his administration has hiked
payments<https://na01.safelinks.protection.outlook.com/?url=https%3A%2F%2Fwww.levernews.com%2Fr%2F1f37d56b%3Fm%3D97cf581e-3056-4108-ad27-b428d8380853&data=05%7C01%7C%7C21d2e86f170a4f9d3cdf08daf568cdf2%7C84df9e7fe9f640afb435aaaaaaaaaaaa%7C1%7C0%7C638092127744493603%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C3000%7C%7C%7C&sdata=dw6cTpywfwLTQ39uB4wS2Gg%2F94GwiBZ9a9ffbCj%2Frvk%3D&reserved=0>
to Medicare Advantage insurers while expanding a
program<https://na01.safelinks.protection.outlook.com/?url=https%3A%2F%2Fwww.levernews.com%2Fr%2F8ac311f6%3Fm%3D97cf581e-3056-4108-ad27-b428d8380853&data=05%7C01%7C%7C21d2e86f170a4f9d3cdf08daf568cdf2%7C84df9e7fe9f640afb435aaaaaaaaaaaa%7C1%7C0%7C638092127744493603%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C3000%7C%7C%7C&sdata=iWUgRnMPQO8Wckv0nA4po2uooNDSDRzGNVtVRVSjoHM%3D&reserved=0>
called ACO REACH that allows companies to enroll seniors on traditional
Medicare into private health care plans without their informed consent.
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But in a significant shift, last month the Biden administration proposed new
regulations<https://na01.safelinks.protection.outlook.com/?url=https%3A%2F%2Fwww.levernews.com%2Fr%2F20f2943e%3Fm%3D97cf581e-3056-4108-ad27-b428d8380853&data=05%7C01%7C%7C21d2e86f170a4f9d3cdf08daf568cdf2%7C84df9e7fe9f640afb435aaaaaaaaaaaa%7C1%7C0%7C638092127744493603%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C3000%7C%7C%7C&sdata=QwfuOWPoUn%2F9Ep9tc6%2BHRftQwlrHa3huHn3fX15pfDs%3D&reserved=0>
to prevent Medicare Advantage insurers from wrongfully denying claims or
refusing to approve services that would be paid under the traditional public
Medicare program.
Consumer advocates like David Lipschutz, associate director of the Center for
Medicare Advocacy, were pleasantly surprised by the proposal — even if it came
a decade late.
Lipschutz noted that the industry response to the proposed claim denial
regulations has been “been pretty muted so far.”
He said insurers are far more concerned about two planned announcements from
the Centers for Medicare and Medicaid Services next month that could have much
greater impact on their bottom line.
“There are potentially hundreds of millions of dollars, if not more, at stake,”
said Lipschutz.
Regulators could decide whether to factor insurers’ upcoding tactics into how
much they pay Medicare Advantage plans. They are also expected to announce a
final audit rule to prevent future overpayments and recoup some of the cost of
excessive disbursements that have gone to Medicare Advantage insurers in the
past.
Speaking at the annual J.P. Morgan Healthcare Conference this week, Humana’s
chief financial officer, Susan Diamond,
said<https://na01.safelinks.protection.outlook.com/?url=https%3A%2F%2Fwww.levernews.com%2Fr%2Fdd755a82%3Fm%3D97cf581e-3056-4108-ad27-b428d8380853&data=05%7C01%7C%7C21d2e86f170a4f9d3cdf08daf568cdf2%7C84df9e7fe9f640afb435aaaaaaaaaaaa%7C1%7C0%7C638092127744493603%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C3000%7C%7C%7C&sdata=Aw8F%2FPA%2FEb97KrhxOEBgiqWeb0yY5EJNM%2FMkTQoP9AU%3D&reserved=0>
“the industry likely will go to litigation” if the final audit rule does not
include a so-called fee-for-service adjuster. Such a provision would allow
insurers to get away with some level of diagnosis coding and billing errors —
and it would likely substantially reduce the sums that insurers would have to
pay back to the government.
The dollars at stake are significant. In September, the office of the inspector
general at the Health and Human Services Department (HHS) released
audit<https://na01.safelinks.protection.outlook.com/?url=https%3A%2F%2Fwww.levernews.com%2Fr%2F9cadc872%3Fm%3D97cf581e-3056-4108-ad27-b428d8380853&data=05%7C01%7C%7C21d2e86f170a4f9d3cdf08daf568cdf2%7C84df9e7fe9f640afb435aaaaaaaaaaaa%7C1%7C0%7C638092127744493603%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C3000%7C%7C%7C&sdata=4o5NG4%2FDyAwh%2BRIj878uMUVcXuPbqWDlLRuSZmkre8w%3D&reserved=0>
reports<https://na01.safelinks.protection.outlook.com/?url=https%3A%2F%2Fwww.levernews.com%2Fr%2F74a28012%3Fm%3D97cf581e-3056-4108-ad27-b428d8380853&data=05%7C01%7C%7C21d2e86f170a4f9d3cdf08daf568cdf2%7C84df9e7fe9f640afb435aaaaaaaaaaaa%7C1%7C0%7C638092127744493603%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C3000%7C%7C%7C&sdata=nrp0D7S0Uh5OVr5FYKQ9gRbhKtstLAo509%2B1IrvDpJI%3D&reserved=0>
finding that even just the Medicare Advantage plans
affiliated<https://na01.safelinks.protection.outlook.com/?url=https%3A%2F%2Fwww.levernews.com%2Fr%2F5eb818a7%3Fm%3D97cf581e-3056-4108-ad27-b428d8380853&data=05%7C01%7C%7C21d2e86f170a4f9d3cdf08daf568cdf2%7C84df9e7fe9f640afb435aaaaaaaaaaaa%7C1%7C0%7C638092127744493603%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C3000%7C%7C%7C&sdata=742Mt5WNsxOQ6NK%2BFoE1X8LSHjJ62WamxjhTAqVy1vs%3D&reserved=0>
with Humana owed the government nearly $44 million worth of overpayments from
2016 and 2017.
A separate HHS inspector general
audit<https://na01.safelinks.protection.outlook.com/?url=https%3A%2F%2Fwww.levernews.com%2Fr%2F31074e39%3Fm%3D97cf581e-3056-4108-ad27-b428d8380853&data=05%7C01%7C%7C21d2e86f170a4f9d3cdf08daf568cdf2%7C84df9e7fe9f640afb435aaaaaaaaaaaa%7C1%7C0%7C638092127744493603%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C3000%7C%7C%7C&sdata=Tz0ZSAIBIT%2B6DhBFGv62UvB9rvEDTVJ5h8Z%2BNUcKHrc%3D&reserved=0>
found<https://na01.safelinks.protection.outlook.com/?url=https%3A%2F%2Fwww.levernews.com%2Fr%2F07c8adcc%3Fm%3D97cf581e-3056-4108-ad27-b428d8380853&data=05%7C01%7C%7C21d2e86f170a4f9d3cdf08daf568cdf2%7C84df9e7fe9f640afb435aaaaaaaaaaaa%7C1%7C0%7C638092127744493603%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C3000%7C%7C%7C&sdata=MiFhkDtnoMSEZF%2BLoChfvL8jBY%2Fhm0ncp7dQXgiCsHo%3D&reserved=0>
a Florida Humana plan overcharged Medicare by nearly $200 million in 2015.
“Prospectively, Not Retroactively”
Medicare Advantage has become a major profit-driver for the insurance industry,
with government funds now accounting for a
majority<https://na01.safelinks.protection.outlook.com/?url=https%3A%2F%2Fwww.levernews.com%2Fr%2F5a9e4401%3Fm%3D97cf581e-3056-4108-ad27-b428d8380853&data=05%7C01%7C%7C21d2e86f170a4f9d3cdf08daf568cdf2%7C84df9e7fe9f640afb435aaaaaaaaaaaa%7C1%7C0%7C638092127744493603%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C3000%7C%7C%7C&sdata=xIj1yWIB6I8uH1c1djKzfeBpeMPFJdqTnzRhrmZkniE%3D&reserved=0>
of most big insurers’ health plan revenues.
That’s especially true for Humana, which received more than 90 percent of its
health plan revenue from taxpayers in 2021. UnitedHealth Group and CVS Health,
which owns Aetna, both brought in more than 70 percent of their health plan
revenue from the government.
Those insurers are part of the Better Medicare Alliance, a health insurance
industry front group that spent nearly $3 million on TV ads promoting Medicare
Advantage between Election Day and the end of the year, according to data from
AdImpact.
<https://na01.safelinks.protection.outlook.com/?url=https%3A%2F%2Fwww.levernews.com%2Fr%2Ff3b487f1%3Fm%3D97cf581e-3056-4108-ad27-b428d8380853&data=05%7C01%7C%7C21d2e86f170a4f9d3cdf08daf568cdf2%7C84df9e7fe9f640afb435aaaaaaaaaaaa%7C1%7C0%7C638092127744649859%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C3000%7C%7C%7C&sdata=MzZUs84BxoVm79Dlk32weBdYoS5vHhs%2F99VdC02VUD0%3D&reserved=0>
[https://img.spacergif.org/v1/150x450/0a/spacer.png]
The Better Medicare Alliance has called
on<https://na01.safelinks.protection.outlook.com/?url=https%3A%2F%2Fwww.levernews.com%2Fr%2Fcad4381f%3Fm%3D97cf581e-3056-4108-ad27-b428d8380853&data=05%7C01%7C%7C21d2e86f170a4f9d3cdf08daf568cdf2%7C84df9e7fe9f640afb435aaaaaaaaaaaa%7C1%7C0%7C638092127744649859%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C3000%7C%7C%7C&sdata=%2FX8rXcwYB64KtucsP7MmaTCT%2BbSCct%2FuG3vVJpYl12w%3D&reserved=0>
the government to audit every Medicare Advantage plan annually “to increase
program oversight and ensure that arbitrary decisions about which contracts are
audited do not disproportionately impact some organizations more than others.”
The group has additionally argued that “changes to audit methodologies should
be applied prospectively, not retroactively,” because doing the former “would
invalidate actuarial assumptions made by health plans over more than a decade
and threaten the care that seniors rely on today.”
Having the audit rule changes apply prospectively would allow insurers to
retain years of overpayments.
Lipschutz said that the Better Medicare Alliance “and the folks that fund them
don’t want to pay out what could be owed to the program looking backwards, so
they want to try to focus on moving forward.”
While the Better Medicare Alliance does not disclose its donors, CVS Health
reported donating $3
million<https://na01.safelinks.protection.outlook.com/?url=https%3A%2F%2Fwww.levernews.com%2Fr%2Fb56d7297%3Fm%3D97cf581e-3056-4108-ad27-b428d8380853&data=05%7C01%7C%7C21d2e86f170a4f9d3cdf08daf568cdf2%7C84df9e7fe9f640afb435aaaaaaaaaaaa%7C1%7C0%7C638092127744649859%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C3000%7C%7C%7C&sdata=pwcsxdxf4pdnOEY6YSOuO6CHyJphGY9DISXhk6ON4t8%3D&reserved=0>
to the group in 2021. Humana gave
$2<https://na01.safelinks.protection.outlook.com/?url=https%3A%2F%2Fwww.levernews.com%2Fr%2F7f5391a4%3Fm%3D97cf581e-3056-4108-ad27-b428d8380853&data=05%7C01%7C%7C21d2e86f170a4f9d3cdf08daf568cdf2%7C84df9e7fe9f640afb435aaaaaaaaaaaa%7C1%7C0%7C638092127744649859%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C3000%7C%7C%7C&sdata=JRoddPRwqxkJ7dW%2FXWt2oNgGumK1Int%2Ffu1SR%2FWWsvM%3D&reserved=0>
million<https://na01.safelinks.protection.outlook.com/?url=https%3A%2F%2Fwww.levernews.com%2Fr%2Fb1b3898b%3Fm%3D97cf581e-3056-4108-ad27-b428d8380853&data=05%7C01%7C%7C21d2e86f170a4f9d3cdf08daf568cdf2%7C84df9e7fe9f640afb435aaaaaaaaaaaa%7C1%7C0%7C638092127744649859%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C3000%7C%7C%7C&sdata=XOTckYVfUJDlEOzCKV4ZObN18%2BxB3KwrK%2FKnSUl9HBo%3D&reserved=0>
that year and $1 million in the first
half<https://na01.safelinks.protection.outlook.com/?url=https%3A%2F%2Fwww.levernews.com%2Fr%2F9ef095de%3Fm%3D97cf581e-3056-4108-ad27-b428d8380853&data=05%7C01%7C%7C21d2e86f170a4f9d3cdf08daf568cdf2%7C84df9e7fe9f640afb435aaaaaaaaaaaa%7C1%7C0%7C638092127744649859%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C3000%7C%7C%7C&sdata=Y9%2FomB6cO1ehibkkprcz7ieiUQSjGKMdgg7OD0Zzr2o%3D&reserved=0>
of 2022.
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Executives from CVS Health, Humana, and UnitedHealth Group
serve<https://na01.safelinks.protection.outlook.com/?url=https%3A%2F%2Fwww.levernews.com%2Fr%2F3c389d66%3Fm%3D97cf581e-3056-4108-ad27-b428d8380853&data=05%7C01%7C%7C21d2e86f170a4f9d3cdf08daf568cdf2%7C84df9e7fe9f640afb435aaaaaaaaaaaa%7C1%7C0%7C638092127744649859%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C3000%7C%7C%7C&sdata=4VZkchHSDbLVxFzKb%2F41W0G3UG%2FplU%2FCWBz3gg25ezc%3D&reserved=0>
on the alliance’s board of directors. (UnitedHealth Group does
not<https://na01.safelinks.protection.outlook.com/?url=https%3A%2F%2Fwww.levernews.com%2Fr%2F53872a44%3Fm%3D97cf581e-3056-4108-ad27-b428d8380853&data=05%7C01%7C%7C21d2e86f170a4f9d3cdf08daf568cdf2%7C84df9e7fe9f640afb435aaaaaaaaaaaa%7C1%7C0%7C638092127744649859%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C3000%7C%7C%7C&sdata=x2Cx5jmgcxz0U3iHaJxjmlYoakQ5As1PbJU69Tf5J4U%3D&reserved=0>
voluntarily disclose its donations to dark money front groups like the Better
Medicare Alliance.)
Humana and CVS Health also
belong<https://na01.safelinks.protection.outlook.com/?url=https%3A%2F%2Fwww.levernews.com%2Fr%2F127a38f6%3Fm%3D97cf581e-3056-4108-ad27-b428d8380853&data=05%7C01%7C%7C21d2e86f170a4f9d3cdf08daf568cdf2%7C84df9e7fe9f640afb435aaaaaaaaaaaa%7C1%7C0%7C638092127744649859%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C3000%7C%7C%7C&sdata=vS0YL06hQP3xOiU5YV5GvBW%2FCpTcBqRmSF3mTNpflGo%3D&reserved=0>
to America’s Health Insurance Plans (AHIP), the powerful D.C. health insurance
industry lobby.
Last summer, AHIP
submitted<https://na01.safelinks.protection.outlook.com/?url=https%3A%2F%2Fwww.levernews.com%2Fr%2Fa1b6bf1b%3Fm%3D97cf581e-3056-4108-ad27-b428d8380853&data=05%7C01%7C%7C21d2e86f170a4f9d3cdf08daf568cdf2%7C84df9e7fe9f640afb435aaaaaaaaaaaa%7C1%7C0%7C638092127744649859%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C3000%7C%7C%7C&sdata=yanlVAmce%2B17Y4jE1avffuPZeJ%2Bnm61OkEmHFWe8yC4%3D&reserved=0>
a comment letter opposing the Medicare Advantage audit rule, arguing it “fails
to account for errors in [fee-for-service] Medicare data” and complaining that
it would apply retroactively.
“Retroactive rulemaking is unfair, inappropriate, and legally impermissible,”
wrote AHIP.
Click Here To
Comment<https://na01.safelinks.protection.outlook.com/?url=https%3A%2F%2Fwww.levernews.com%2Fr%2F574236a4%3Fm%3D97cf581e-3056-4108-ad27-b428d8380853&data=05%7C01%7C%7C21d2e86f170a4f9d3cdf08daf568cdf2%7C84df9e7fe9f640afb435aaaaaaaaaaaa%7C1%7C0%7C638092127744649859%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C3000%7C%7C%7C&sdata=aFyJk6EZDFogEUGdl%2B86SwCTC3HVYE0mIvowypc3O5A%3D&reserved=0>
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