Tell President Biden: Protect Medicare from Corporate Greed!

Medicare is an essential public program that provides universal health coverage to millions of seniors and disabled Americans. But Medicare is under attack from corporate greed through a program called Medicare Advantage. Medicare Advantage plans use hefty taxpayer subsidies to offer consumers cheaper premiums, but then often fail to provide patients with adequate care when they need it and limit patients to small provider networks. Recent investigations have found that the largest insurers in Medicare Advantage have committed widespread fraud and denied patients critical care they were supposed to provide by law.

Medicare Advantage exemplifies why the profit motive has no place in healthcare. The billions of our taxpayer dollars that get spent on Medicare every year should go to providing people with healthcare, not making greedy CEOs richer.

That’s why we’re calling on President Biden to ensure that people and patients on Medicare get the health care they need and deserve.

President Biden must direct his administration to do everything in their power to:

Improve Medicare so that people have the freedom to just choose Medicare.
Stop wrongful delays and denials of care in Medicare Advantage plans.
Hold corporations accountable by ending rampant profiteering, kicking the bad actors out and mandating transparency in Medicare advantage plans.

Add your voice to this petition calling on President Biden to take executive action—whether you’re on Medicare, Medicare Advantage, or just believe in protecting one of our most valued public programs.

First Name *

Last Name *

Email Address *

Phone Number *

Zip Code *

Representatives

Your Letter *

The Medicare Advantage program was created with the promise that the private sector could reduce costs by better managing care. But as these plans have captured nearly half of the market for Medicare, there is increasing evidence that insatiable profit seeking by these plans has done the opposite. Taxpayers are not getting our money’s worth. But most tragically, too many elders and disabled people on Medicare Advantage plans are not getting the care they need and deserve.

Your Administration should escalate its response to this crisis and further step up your efforts to defend the rights of older Americans and people with disabilities by combating profiteering, waste, misconduct and fraud in Medicare Advantage Plans. The very integrity of the Medicare program, which seven decades of Americans have come to cherish and rely on, is at stake. 

We are asking you to center the goal of all people on Medicare getting the health care they need and deserve. For this reason, I am outlining critical actions your Administration can and should take in response. 

1. Improve Medicare so that people have the freedom to just choose Medicare.
● Actively promote and endorse legislation to level the playing field between Medicare Advantage (MA) and Traditional Medicare (TM) by enacting an out-of-pocket cap in TM that is on par with MA, expanding federal Medigap rights and the ability of patients to switch from MA to TM, and expanding access to vision, dental and hearing to all Medicare beneficiaries.
● More actively promote and advocate for increased funding and capacity for State Health Insurance Assistance Programs (SHIPs) and Senior Medicare Patrol (SMP).
● Pass on savings harnessed from reining in MA overpayments into lowering the cost of Traditional Medicare to consumers and expanding Medicare benefits for all beneficiaries, including by adding an out-of-pocket cap, dental, vision and hearing benefits.

2. Stop wrongful delays and denials of care in Medicare Advantage plans. 
● Immediately forbid the use of AI and robo-denials in medical necessity determinations, and instead require plans to use the Medicare process for medical necessity determinations.
● Accelerate plan decision time-frames (as proposed in the interoperability rule) to prevent delays in approvals and treatment.
● Require MA plans to strengthen access to providers and explore imposing a requirement that MA plans include all National Cancer Institute centers of excellence in their networks.
● Require plans to cover services for all prior authorization requests to which a payer does not respond within the specified time frame.
● Issue warnings to people enrolled in plans using AI and robot-denials to delay and deny care, suspend all enrollment in those plans and/or allow people to disenroll from these plans to another plan or into Traditional Medicare with guaranteed issue of Medigap.
● Suspend star-ratings for MA plans that fail to comply with contractual obligations to apply Medicare medical necessity protocols, to release accurate and complete encounter data, to have accurate provider directories, and to code appropriately.
●Impose harsh penalties on plans that use coverage criteria that are more restrictive than traditional Medicare rules.

3. Hold corporations accountable by ending rampant profiteering, kicking the bad actors out and mandating transparency in Medicare advantage plans. 
● Mandate timely disclosure of MA plan denial rates, mortality rates, disenrollment rates and CMS should cancel contracts with all MA plans that persistently have high denial, mortality and/or disenrollment rates.
● Standardize MA benefits in order to allow individuals to make meaningful comparisons between plans.
● Require MA plans to pay providers Traditional Medicare rates.
● Strengthen consumer protections surrounding plan marketing beyond what was proposed in the Medicare Part C & D rule, including further oversight of plan advertising and addressing agent/broker compensation issues.
● Adjust Medicare Advantage per enrollee payments so that they are at least on par with those in traditional Medicare, or even return to 95% of TM rates, as originally promised.
● Implement a system of automatic penalties on MA plans, when they violate their obligations, that escalate rapidly with repeated failures to comply. Consequences should include, but not be limited to suspension of marking and enrollment and termination of contracts.
● Impose more robust data sharing requirements on insurance corporations offering Medicare Advantage plans, including encounter data and prior authorization. Protocols, and impose escalating penalties for plans that fail to deliver required data.
● Levy financial penalties on Medicare Advantage plans that are experiencing significant migration of enrollees to traditional Medicare.
● Increase its capacity to annually audit plans to ensure compliance with Medicare coverage and appeals rules, including allocating sufficient staff and resources to carefully review all plan bids and conduct discriminatory impact reviews.
● Seize the mantle of reform to urge bold congressional action and drive a powerful narrative around holding Medicare Advantage plans accountable.

You have the power to make this happen.  We are all counting on you, Mr. President!

Your signature will automatically be added to your letter.

I am interested in Volunteering

Yes

Leave this field blank

This campaign is hosted by Be a Hero Fund. By providing your email address and cell phone number you consent to receive a follow up text and/or emails from Be a Hero Action Fund. Read our privacy policy here.