Insurance Industry, Biden Admin Trade Barbs Over Medicare Advantage ‘Cuts’

In the view of Medicare Advantage organizations (MAOs) and their allies, federal regulators have been unjustifiably assailing an increasingly popular program among seniors. But to the Biden administration, MAOs’ complaints are unfounded — and their attempt to paint the latest round of proposals as a pay cut is intentionally misleading.

To one longtime health care industry observer, both sides’ arguments amount to “just a lot of noise” that doesn’t do much to prove their cases in the court of public opinion.

As for whether MAOs are actually in line for a pay cut, “it’s one of those things where it’s too close to call…and they’re arguing in the review booth at an NFL game,” says John Gorman, who worked at CMS during the Clinton administration and is now chairman and CEO of Nightingale Partners LLC.

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Leslie Small

Leslie Small

Leslie has been working in journalism since 2009 and reporting on the health care industry since 2014. She has covered the many ups and downs of the Affordable Care Act exchanges, the failed health insurer mega-mergers, and hundreds of other storylines spanning subjects such as Medicaid managed care, Medicare Advantage, employer-sponsored insurance, and prescription drug coverage. As the managing editor of Health Plan Weekly and Radar on Drug Benefits, she writes and edits for both publications while overseeing a small team of reporters who also focus on the managed care sector. Before joining AIS Health, she was a senior editor for the e-newsletter Fierce Health Payer, and she started her career as a copy editor at multiple local newspapers. She graduated with a dual degree in journalism and political science from Penn State University.

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