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Chutzpah Redefined - Call For Citizen Policing of Medicare Advantage

Biden administration is asking the public to report on bogus advertising claims of Medicare Advantage providers.

Biden administration is asking the public to report on bogus advertising claims of Medicare Advantage providers.

• Topics: Government, Business, Health,

Any sane person is yearning for the moment when the advertising of Medicare Advantage (MA) plans during “open season” ends. Endless argle-bargle fills the airways and mail boxes while the Biden administration, in the guise of the Center for Medicare Services (CMS), posts yet again “new” rules and asks the public to report on bogus advertising claims of services to those covered by Medicare.

But these new rules are just putting lipstick on the pig of Medicare Advantage which is legalized robbery from the Medicare trust fund to begin with. Biden is making things less bad? Is that the message?  Sheesh.

Physicians for a National Health Plan (PNHP) issued a report that reveals:

“By our estimate, and based on 2022 spending, MA overcharges taxpayers by a minimum of 22% or $88 billion per year, and potentially by up to 35% or $140 billion. By comparison, Part B premiums in 2022 totaled approximately $131 billion, and overall federal spending on Part D drug benefits cost approximately $126 billion. Either of these—or other crucial aspects of Medicare and Medicaid—could be funded entirely by eliminating overcharges in the Medicare Advantage program.”

The entirety of the Medicare Advantage program is corrupt.  It is time to completely eliminate the MA program and replace it with single payer, that is, Medicare for All!

But in lieu of any actual action, “Officials at the Centers for Medicare & Medicaid Services are encouraging seniors and other members of the public to become fraud detectives by reporting misleading or deceptive sales tactics to 1-800-633-4227, the agency's 24-hour information hotline. Suspects include postcards designed to look like they're from the government and TV ads with celebrities promising benefits and low fees that are available only to some people in certain counties.”  ["Uncle Sam wants you to help stop insurers' bogus Medicare Advantage sales tactics", NPR Shots Health News, 30 Nov 23]

According to CMS, those enrolled in Medicare should be wary of sales pitches that:

  • Suggest benefits are available to all who sign up when only some individuals qualify.
  • Mention benefits that are not available in the service area where they are advertised (unless unavoidable because the media outlet covers multiple service areas).
  • Use superlatives like "most" or "best" unless claims are backed up by data from the current or prior year.
  • Claim unrealistic savings, such as $9,600 in drug savings, which apply only in rare circumstances.
  • Market coverage without naming the plan.
  • Display the official Medicare name, membership card, or logo without approval of CMS, the federal agency in charge of Medicare.
  • Contact you, if you're an Advantage or drug plan member, and you told that plan not to notify you about other health insurance products.
  • Pretend to be from the government-run Medicare program, which does not make unsolicited sales calls to beneficiaries.

But why try to police this bunko by nibbling around the edges of its corruption? It occurred to me that all Medicare recipients should respond to this request from Biden/CMS by reporting the entire Medicare Advantage program as being a massive fraud that sucks billions of dollars out of the trust fund each year. 


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Comments by Readers

Kerry Johnson

Dec 02, 2023

Good essay, Richard.


One quibble is that even “single payer” is a half-way measure—a true “national health service” would be a more ideal solution, I sense

Take care


Dick Conoboy

Dec 02, 2023


I would tend to agree with you but what you are suggesting is creating an extraordinarily huge government agency nationwide.  That might take years or even a decade.  I am not opposed but I am also not sure how to go about it.  Imagine the size of a  bill in congress to create such an organization!   Do you have any literature or links to organizations that are pushing for that.  I would be interested in that kind of info.




M. Lynda Hanscome

Dec 03, 2023

I agree with Dick, totally.  And the newest scam of ACOs-direct- contracting (Accountable Care Organization) by CMS  with for-profit companies, I believe, will replace Medicare DisAdvantage scammers in the future.  These for-profits ‘enroll’ traditional medicare recepients without their knowledge or consent. 

If you are a patient of Peace Health and you are not in Medicare DisAdvantage, you are in their ACO scam; your doctor’s employment depends on him joining.   Oh, and Peace Health will ask your permission to tape the doctor/patient meeting.  Say NO.  It is your Doctor’s ACO who decides your health path.  So what started out as a “Pilot” program has gone pretty much underground while the CMS and the for-profits tidy up their game plan to raid Medicare funds.  The for-profits contract with health delivery sites like hospitals, clinics, etc..  And they refuse to take the trapped patients out even when asked multiple times. 


These “pilots” operate under the auspicies of the CMS so they are already working to rob Medicare using the VERY SAME tactics as Medicare DisAdvanage…upcoding diagnosis to make it look like people are sicker than they really are; then they delay or deny treatments options….like 6 treatments ends up being 3 treatments and they keep the money based on the fraud.  Who is going to track every single penny down the road to ensure what was promised was delivered?  The ACOs make a big deal of “returning” money to CMS each year by providing care that is overstated and throttled back and call it ‘savings.  Finally, the ACOs take up to 40% from Medicare as “service fees” (theft). 


Geoff Middaugh

Dec 03, 2023

Thanks for the article.   Looks like we have a call to the Fraud Line in our future.  


Kerry Johnson

Dec 03, 2023

Hi, Dick!

I seemed to have learned from the Obama fake healthcare fiasco that we ought to FIRST ... ASK FOR WHAT WE WANT.  We can consider comprimises at some points, but we ought NOT to start with something less than what we really want and need.  I’m not saying that this “ask” is at all practical, given our current corrupt political (legal bribary) system.  We will need a system-change first, but if that can somehow be positively brought about, we we do best to have our goals clearly in mind.  I’ve become more and more socialist as I’ve read more and more about how things work in the world.  I believe that ALL of our basic needs and functions ought to be under the direct auspices of our government, maybe starting with banking/finance, and working from there.  Thanks


Dick Conoboy

Dec 03, 2023


I view single payer as a step on a path to a national health system.  For those who are not familiar with the single payer concept, you can read more at this link for the Physicians for a National Health Plan.  

And I agree that money is part of the commons and should not be in private banks or other such institutions.  Public banking, as they have had in North Dakota for over 100 years should be the rule nationwide.  You can find all my articles on public banking on this site here by scrolling down the right hand column.



David A. Swanson

Dec 04, 2023

“argle bargle” - a descriptor for the ages. Way better than Jiber-jabber. 


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