OPINION — It has come to my attention that some of the largest Medicare Advantage plans have been identified by Health and Human Services and Office of Inspector General as having engaged in questionable denials of some Medicare benefits.
This information was disclosed in HHS OIG report dated June 8, 2026, (OEI-09-24-00330).
Under a Medicare Advantage plan, Medicare Part B dollars are managed by a for-profit insurance company that determines necessary care. According to the OIG report, decision-making for certain types of covered care may not coincide with Medicare rules which Medicare Advantage is required to follow.
