Congress Calls for GAO Probe into Medicare Advantage Plan Acquisitions

Growing scrutiny surrounds Medicare managed care plans in the United States, as two key members from the House Ways and Means Committee, Representatives Lloyd Doggett and Greg Murphy, urge the Government Accountability Office (GAO) to investigate the increasing trend of these plans acquiring health-related businesses.

This practice may enable these Medicare Advantage organizations to circumvent federal norms mandating that at least 85% of revenues be spent directly on beneficiary healthcare. The congressional concern highlights potential impacts on the industry’s regulatory landscape, specifically regarding the adherence to the medical loss ratio (MLR) standards set for these organizations.

The investigation could lead to significant implications for compliance and transparency in the increasingly integrated healthcare market.