Here are six updates on Medicare Advantage that have made headlines recently, as reported by Becker's since June 25:
1. Fort Myers, Fla.-based Lee Health's Physician Group primary care providers will be out of network with Florida Blue's Medicare Advantage plans by September.
2. Medicare Advantage plans received $50 billion in payments between 2018 and 2021 for "questionable diagnoses" insurers added to medical records, a Wall Street Journal investigation found. The Journal investigated billions of Medicare Advantage records and found that some conditions were diagnosed at a much higher rate among Medicare Advantage beneficiaries than among traditional Medicare beneficiaries.
3. A federal judge paused the implementation of CMS regulations capping the amount Medicare Advantage companies can pay brokers that sell their plans.
4. A new law in Delaware requires the state to offer its retired state employees Medicare supplement plans rather than Medicare Advantage plans. The law prevents the state from offering Medicare Advantage to currently retired state employees. The state could still consider Medicare Advantage coverage for employees hired in 2025 and beyond.
5. New York City's teachers union pulled support for the city's shift to Medicare Advantage, further complicating the controversial effort. New York City has been trying to implement a Medicare Advantage contract for retirees since 2021. The teacher's union President Michael Mulgrew said he reversed his position on the contract because Mayor Eric Adams' administration was unwilling to continue work on the Medicare Advantage contract in good faith, prioritizing cutting costs over providing quality care access.
6. Lawmakers have pressured CMS to do more to prevent misuse of artificial intelligence by Medicare Advantage plans. A group of 51 lawmakers signed a letter to CMS Administrator Chiquita Brooks-LaSure asking the agency to implement more stringent oversight regarding the technology.