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A study by the OIG has shown that Medicare Advantage plans have routinely denied necessary medically care as well as payments to physicians. They found that 13% of denied care met Medicare rules and 18% of payments denied were legitimate. Most of the illegally denied care were for advanced imaging by asking for too much pre authorization and flat denying care.
Maine Medical Center, the largest hospital ion the state, is leaving a contract with Anthem in January 2023 due to they being owed over $13 million by the insurer. Anthem blames the hospital fees.
Some hospitals are relaxing or dropping mask requirements. They also have problems with the CDC and there rule making.
DISCLAIMER: Although this article is updated periodically, it reflects the author's point of view at the time of publication. Nothing in this article constitutes legal advice. Readers should consult with their own legal counsel before acting on any of the information presented.