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Hospitals dropping Medicare Advantage agreements leaves patients in lurch
"The underlying issue is that health providers, whether doctors or hospitals, are demanding more payment for their services rendered to those on Medicare, and the Medicare Advantage plans are refusing to pay more," said Mississippi Insurance Commissioner Mike Chaney.
Hospitals nationwide complain that Medicare Advantage providers routinely deny payment for services, driving up administrative costs for appealing the denials. Insurance providers say doctors and hospitals try to charge too much or prescribe unwarranted expensive medications and procedures.
North Mississippi Health Services CEO Shane Spees recently told the Northeast Mississippi Daily Journal that only 4 percent of his company's patients use Humana Medicare Advantage, but they account for 85 percent of payment denials for all payers.
"The underlying issue is that health providers, whether doctors or hospitals, are demanding more payment for their services rendered to those on Medicare, and the Medicare Advantage plans are refusing to pay more," said Mississippi Insurance Commissioner Mike Chaney.
Hospitals nationwide complain that Medicare Advantage providers routinely deny payment for services, driving up administrative costs for appealing the denials. Insurance providers say doctors and hospitals try to charge too much or prescribe unwarranted expensive medications and procedures.
North Mississippi Health Services CEO Shane Spees recently told the Northeast Mississippi Daily Journal that only 4 percent of his company's patients use Humana Medicare Advantage, but they account for 85 percent of payment denials for all payers.