医疗保健福利计划面临检查,因为要将病人的风险分数膨胀,以获得更高的联邦付款,每年费用为83B美元,并促使人们呼吁改革。 Medicare Advantage plans face scrutiny for inflating patient risk scores to gain higher federal payments, costing $83B annually and prompting calls for reform.

医保福利计划正在接受审查,因为据称计划将病人的风险分数膨胀,以确保政府支付更高的费用,可能使纳税人每年付出830亿美元的代价。 Medicare Advantage plans are under scrutiny for allegedly inflating patients’ risk scores to secure higher government payments, potentially costing taxpayers $83 billion annually. 据报告,United Health Security和Humana等保险人列出许多条件,使得分(37%)和得分(19%)分别高于平均水平——导致联邦报销额大幅提高,而给医生的付款比传统医疗保险低11%。 Insurers like UnitedHealthcare and Humana are reported to list numerous conditions to boost scores—37% and 19% above average, respectively—leading to significantly higher federal reimbursements while paying doctors 11% less than traditional Medicare. 这些差异促使一些服务提供者退出该方案,减少了病人的就诊机会。 These disparities have prompted some providers to exit the program, reducing patient access. 一项拟议的众议院法案,即《迅速和公平薪酬法》,旨在要求平等报销医生费用,解决操纵的诱因,并引起对该方案中的问责制和公平性的关切。 A proposed House bill, the Prompt and Fair Pay Act, aims to require equal doctor reimbursements, addressing incentives for manipulation and raising concerns about accountability and fairness in the program.