Medicare Advantage Plans draw scrutiny from Congress

A report from The Virginia Senior Medicare Patrol (SMP) blog - July 27, 2022

On June 28, the House Energy and Commerce Subcommittee on Oversight and Investigations held a hearing entitled

“Protecting America’s Seniors Oversight of Private Medicare Advantage Plans.”

The hearing examined the quality of care seniors are receiving Through Medicare Advantage Plans and the fiscal sustainability of the Medicare Advantage Program. The committee heard reports related to dis-enrollment rates, denial of access to medical care, and prior authorization requirements, among other issues.

Read more about it at Government Watchdogs Attack Medicare Advantage for Denying Care and Overcharging – The Virginia SMP:

“The SMP mission is to empower and assist Medicare beneficiaries,

their families, and caregivers to prevent, detect, and report healthcare fraud,

 errors, and abuse through outreach, counseling and education.”

The Virginia SMP – VA Senior Medicare Patrol

The Inflation Reduction Act which was just signed into law by President Biden contains some Medicare Part D prescription drug provisions aimed at lowering the amount that beneficiaries pay for some medications. Not all benefits will start immediately.

(Check out the timeline chart below) 

Here are some highlights:

• Requires the federal government to negotiate prices for some top-selling drugs covered under Medicare.
• Requires drug companies to pay rebates if prices rise faster that inflation, for drugs used by Medicare beneficiaries.
• Eliminates the 5% coinsurance for those who reach the catastrophic coverage level in Part D.
• Puts a $2,000 cap on Part D out-of-pocket spending in 2025.
• Limits annual increases in Part D premiums for 2024-2030.
• All Part D plans will limit monthly cost-sharing amount for insulin products to $35.
• Medicare Part D Low-Income-Subsidy (Extra Help) eligibility will be expanded.
• Eliminates cost-sharing for adult vaccines covered under Medicare Part D. Improves access to adult vaccines under Medicaid.                                                                                                

For more information:

• visit VICAP Medicare Counseling Program
• call 703-737-8036 
• email VICAP