April 01, 2025

Axios: First look: Warren outlines plan for revamping MA

Sen. Elizabeth Warren and a group of Democratic senators are laying out a four-step plan to crack down on Medicare Advantage overpayments and make other changes to improve the program.

Why it matters: CMS administrator nominee Mehmet Oz has supported the MA program but during his confirmation hearing criticized some insurer practices, such as categorizing patients as sicker to get higher payments.

What's inside: The plan is described in a letter shared first with Axios that's signed by Warren, Richard Blumenthal, Cory Booker, Dick Durbin, Ed Markey, Jeff Merkley, Bernie Sanders and Tina Smith.

  • It calls on CMS to take four steps aimed at improving the quality of the MA program and saving taxpayers money.
  • One is to eliminate waste and abuse from overpayments by improving risk adjustment calculations in the proposed 2026 MA rate notice, and by strictly enforcing the overpayment regulations outlined in the 2025 Medicare physician fee schedule.
  • Other proposals include strengthening enforcement against MA insurers that illegally deny care - especially through prior authorization - and addressing additional barriers like the use of AI to deny services. The letter also calls for action to reduce health disparities.

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Read the full article here.


By:  Victoria Knight
Source: Axios