Democrats Eye Medicare Managed-Care Plans to Fund New Benefits

Medicare managed-care plans say they’ll have to increase premiums and reduce benefit offerings if Democrats cut their program reimbursements to help pay for new dental, vision, and hearing benefits in traditional Medicare.

Because these Medicare Advantage plans receive higher payments for beneficiaries with more ailments and higher expected medical costs, plan providers typically record all possible medical diagnoses, which often results in overpayments, according to the Medicare Payment Advisory Commission. In 2019, the commission estimates that MA plans received nearly $9 billion in excess payments due to this “coding intensity.”

As Democrats work to trim their $3.5 trillion reconciliation package ...