$18 Billion in Medicare Cuts & Man Sentenced in $34 Million Medicare Scam

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In this week’s Medicare round-up, a California man was sentenced in a $34 billion Medicare scam, and you could be OVERSPENDING on your insurance. We have a recap of the top Medicare news stories you may have missed!

House Passes Bill to Avert $18 Billion in Medicare Cuts

The U.S. House passed a bill that would stop cuts to Medicare payments. The move helps Medicare providers still feeling the financial effects of COVID-19. It passed Tuesday with a solid bipartisan majority vote of 384-38. The 2% cuts will remain on hold until the end of the year.

The legislation comes almost two weeks after the cuts were scheduled to take effect. Medicare provider groups, who have spent months lobbying Congress for an extension, have applauded the decision. President Biden is expected to sign the bill into law.

Medicare Advantage Members Vs. Fee-For-Service Beneficiaries

A new United Health study found Medicare Advantage beneficiaries save up to 40% a year, compared to people enrolled in a private fee-for-service plan. Fee-For-Service is when doctors and health care providers are paid based on the services performed. The study found the average spending costs per year (including premiums and out-of-pocket costs) for beneficiaries enrolled in traditional Medicare alone was $5,361.

Medicare Advantage beneficiaries paid significantly less. Their yearly costs came up to $3,558 per person. However, the caveat is that those who were not healthy on a Medicare Advantage plan could’ve easily reached their Maximum Out of Pocket limit. Those who planned for the worst protected their finances by enrolling in a Medigap plan. They chose to pay an additional monthly premium to keep them far away from the out-of-pocket limit.

Researchers said a beneficiary’s estimated health care spending played a key factor in what type of supplemental plan they chose. 

Medicare Coverage for Devices May Slow Down 

The future of Medicare’s Coverage of Innovative Technology pathway is up in the air. Last year, President Trump proposed an executive order on Protecting and Improving Medicare for Our Nation’s Seniors. President Biden has not announced how the administration plans to handle the drug and device regulation.

California Man Sentenced in $34 Million Medicare Fraud

This week, a judge sentenced a Glendora man to two years in prison for his role in a $34 million healthcare scam. Federal authorities said the scam included kickbacks and bribes used to manipulate Medicare to pay for unnecessary medical equipment. Najib Jabbour, 47, goes to prison in less than three months. In addition to his sentence, Jabbour and his co-conspirator Darrin Fashber, 41, will have to pay $1.1 million in restitution.

Federal authorities arrested two dozen other people, including doctors. Authorities say the men ripped off millions from Medicare through medical supply companies they operated and owned. Court records show they submitted $34 million in fraudulent claims. Medicare only paid about $17.2 million. Medicare lost more than $1.2 billion.

And that’s a recap of your top Medicare news stories of the week!

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