Daily Action for Tuesday, May 3rd, 2022
The Health and Human Services Department released a report in April analyzing the denial of benefits from Medicare Advantage plans, health insurance plans that provide Medicare through private insurance. The report found that 13 percent of denied claims should have been covered under Medicare.
Separately, the Biden administration is redesigning a Trump-era Medicare pilot program called Global and Professional Direct Contracting (GPDC) that moved towards the privatization of Medicare. The newly renamed program, Accountable Care Organization realizing equity, access, and community health (ACO REACH), includes numerous changes and a name change but does NOT dismantle the privatization model that makes this program dangerous.
Today’s daily action is to contact your elected officials and urge them to crack down on Medicare Advantage providers denying covered treatment, and also to oppose any further privatization of Medicare (including the ACO REACH program)
ACTION: Crack down on Medicare Advantage providers denying covered treatment
Contact your Representative:
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PRAMILA JAYAPAL: 202-225-3106 OR HTTP://JAYAPAL.HOUSE.GOV/CONTACT
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ADAM SMITH: 202-225-8901 OR HTTP://ADAMSMITH.HOUSE.GOV/CONTACT
Contact your Senators:
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MARIA CANTWELL: 202-224-3441 OR HTTPS://WWW.CANTWELL.SENATE.GOV/CONTACT/EMAIL/FORM
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PATTY MURRAY: 202-224-2621 OR HTTPS://WWW.MURRAY.SENATE.GOV/WRITE-TO-PATTY/
Script
Hi, my name is [NAME] and I live in Seattle. Last month, the Health and Human Services Department released a report finding that 13 percent of denied claims through Medicare Advantage plans should have been covered under Medicare. I’ve also seen that the Biden administration is revamping the Global and Professional Direct Contracting program, but is NOT dismantling the privatization pilot program that Trump started.
The further privatization of healthcare creates perverse incentives where healthcare providers are beholden to shareholders and private equity firms rather than doing what they’re supposed to do: provide healthcare. I urge you to crack down on Medicare Advantage providers denying claims they should be covering and to please fight against the rebranded ACO REACH program. Healthcare is a human right and should NOT be privatized.
Background
NYT: Medicare Advantage Plans Often Deny Needed Care, Federal Report Finds
https://www.nytimes.com/2022/04/28/health/medicare-advantage-plans-report.html
Department of Health and Human Services Report
https://oig.hhs.gov/oei/reports/OEI-09-18-00260.pdf
Bloomberg Law: Trump-Era Medicare Pilot Program to Get Reboot From Biden HHS
https://news.bloomberglaw.com/health-law-and-business/trump-era-medicare-pilot-program-to-get-reboot-from-biden-hhs
