Cameron Medical Center skeptical of Medicare Advantage

Dec. 31—Cameron Regional Medical Center started looking into whether it should stop accepting some Medicare Advantage plans early in 2022, placing it among a few hospitals in the U.S. that were doing so.

In November, the hospital announced that Cigna Medicare Advantage will no longer be accepted as an in-network health plan starting in 2023.

Medicare is health insurance that is federally provided for patients 65 or older. Medicare Advantage offers similar services but through private insurance companies.

There’s evidence that there is a potential incentive for Medicare Advantage agencies to increase profits by denying payment or access to services, according to a review done by the Office of the Inspector General within the U.S. Department of Health and Human Services.

“They are delaying any action on reimbursement,” Cameron Regional CEO Joe Abrutz said in an exclusive interview on Nov. 6. “And you would think in this inflationary environment that we’re in now, especially with the American hospital, that we would get some sort of respect for saving lives.”

The hospital continues to investigate whether it should stop accepting most Medicare Advantage plans.

Reports also were released in the fall that some Medicare Advantage plans had been overcharging patients and sidestepping government regulations.

Further steps were taken in mid-December at the federal level, with a proposed rule to prevent misleading or confusing Medicare Advantage ads.

As of now, Mosaic Life Care continues to accept Medicare Advantage.

Alex Simone can be reached at alex[email protected]. Follow him on Twitter at @NPNOWSimone.