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Will Medicare Advantage see significant regulatory reform by end of 2025?
2
Resolution / Starting Odds
Yes • 50%
No • 50%
Official announcements from the Centers for Medicare & Medicaid Services (CMS) or relevant government legislation
Story
WSJ Investigation Reveals UnitedHealth Group Extracted $50 Billion from Medicare Advantage (2019-2021)
Jan 2, 2025, 04:16 PM
A yearlong investigation by The Wall Street Journal has revealed that major insurers, including UnitedHealth Group, extracted billions in additional payments from the Medicare Advantage system. The investigation found that from 2019 to 2021, insurers diagnosed patients with conditions that led to an extra $50 billion in payments, despite no actual treatment for these diseases. The report highlights practices such as providing doctors with checklists of potential diagnoses and offering bonuses for completing them, raising concerns about the integrity of the Medicare Advantage program and its impact on the sickest Americans.
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Stricter regulations implemented • 25%
Other outcomes • 25%
No significant changes • 25%
Fines imposed on insurers • 25%
No • 50%
Yes • 50%
Leadership restructuring • 25%
Other changes • 25%
No major changes • 25%
Increased security measures • 25%
No • 50%
Yes • 50%
No significant reform passed • 25%
Comprehensive reform bill passed • 25%
Partial reform measures passed • 25%
Reform bill introduced but not passed • 25%
