Sunday Links

You’re Like Captain Marvel—Only Real!



Here’s a great summary of the comments submitted to CME in response to their 2020 call letter

Spoiler alert:

  1. Insurance companies are shameless.
  2. Someone is paying trolls to suck up to CMS by sending in comments of such slavering support they can only be explained as such.



Of Interest:

Medicare Advantage enrollment by state.

By Plan



Medicare Advantage plans paid fewer fines in 2018

2015—$8.4m from 18 MAOs audited

2018—$0.2m (this is not a typo) from 38 audited MAO plans

MA enrollment increased by 10% during that time frame

MAOs by about 20%

CMS says it’s because beneficiaries are migrating towards more compliant plans—but regulatory capture is a more reasonable explanation.


Recovery Audit Contractors were approved by statute almost 10 years ago.

Where are they?





“The difference between mediocre and superior Medicare Advantage performance lies in the systematic collection of the common diagnostic risk codes with persistence in the search for the esoteric ones.”