• Forrest Bohler and Eli Y Adashi.
• From the Medical Student, Oakland University William Beaumont School of Medicine, Rochester, MI (FB); Professor of Medical Science, Former Dean of Medicine and Biological Sciences, Brown University, Providence, RI (EYA). forrestbohler@yahoo.com.
• J Am Board Fam Med. 2024 May 1; 37 (3): 494496494-496.

AbstractThe Medicare Advantage (MA) Program, home to nearly half of the eligible Medicare population, has recently come under increased scrutiny. Recent investigations conducted by the United States Senate Committee on Finance and Centers for Medicare & Medicaid Services (CMS) have uncovered marketing practices of MA insurance agents that "were not complying with current regulation and unduly pressuring beneficiaries, as well as failing to provide accurate or enough information to assist a beneficiary in making an informed enrollment decision." These findings come at a time in which MA programs are under investigation for denials of prior authorization requests that fall within Medicare guidelines for covered health services. In this Commentary we consider the backdrop for the growing scrutiny of the MA program and the implications thereof to its future trajectory.© Copyright 2024 by the American Board of Family Medicine.

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