{"id":21812,"date":"2025-03-25T17:32:56","date_gmt":"2025-03-25T21:32:56","guid":{"rendered":"https:\/\/www.merkley.senate.gov\/?p=21812"},"modified":"2025-04-09T15:51:11","modified_gmt":"2025-04-09T19:51:11","slug":"cassidy-merkley-introduce-bill-to-stop-overpayments-in-the-medicare-advantage-program","status":"publish","type":"post","link":"https:\/\/www.merkley.senate.gov\/es\/cassidy-merkley-introduce-bill-to-stop-overpayments-in-the-medicare-advantage-program\/","title":{"rendered":"Cassidy, Merkley Introduce\u00a0Bill to Stop Overpayments in the Medicare Advantage Program"},"content":{"rendered":"

WASHINGTON \u2013\u00a0<\/strong>U.S. Senators Bill Cassidy, M.D. (R-LA)\u00a0and\u00a0Jeff Merkley (D-OR) introduced the\u00a0No Unreasonable Payments, Coding, or Diagnoses for the Elderly (No UPCODE) Act<\/a>\u00a0to improve the way Medicare Advantage plans assess patients\u2019 health risks and reduce overpayments for care. The No UPCODE Act will save taxpayers billions by eliminating incentives to overcharge Medicare for care.<\/p>\n\n\n\n

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\u201cMedicare is going insolvent, and our budget deficit is expanding. We need to stop overpaying where we can if we\u2019re to preserve Medicare for Americans who rely on it,\u201d dijo el Dr. Cassidy. <\/strong>\u201cThis is the direction we need to go.\u201d<\/p>\n<\/blockquote>\n\n\n\n

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\u201cFraud, waste, and abuse by bad actors are destroying the stability of both Medicare Advantage and traditional Medicare\u2014this must end,\u201d dijo el senador Merkley. <\/strong>\u201cOur bipartisan bill cracks down on the fraudsters overcharging taxpayers by billions of dollars every year, closing the loopholes they use to turn sick patients into healthy profits.\u201d<\/p>\n<\/blockquote>\n\n\n\n

Traditional Medicare plans reimburse providers for the cost of treatments rendered, while Medicare Advantage is paid a standard rate based on the health of an individual patient. Because of this, Medicare Advantage plans have a financial incentive to make beneficiaries appear sicker than they may be to receive a higher Medicare reimbursement.\u00a0According to a\u00a0CBO budget option report<\/a>, addressing overcoding will save $124 billion over 10 years.\u00a0<\/p>\n\n\n\n

The No UPCODE Act would eliminate those incentives by:<\/p>\n\n\n\n