Latest news with #AHIP
Forbes
11 hours ago
- Health
- Forbes
Health Insurers Call Out Trump On Promise To Not Cut Seniors' Medicare
The nation's health insurance companies say legislation wending its way through the Republican-controlled Congress would break a promise by Donald Trump and the GOP not to cut Medicare benefits to seniors. It's the latest part of the healthcare industry to fight back against proposed federal cuts in healthcare benefits to millions of Americans. Already, physicians led by the American Medical Association have launched an ad campaign targeting U.S. Senators in an effort to thwart the budget legislation. Legislation known as the 'One Big Beautiful Bill Act' that narrowly passed the Republican-controlled U.S. House of Representatives two weeks ago would reduce federal Medicaid spending by $793 billion and increase the number of uninsured by 7.8 million, a KFF analysis shows. But the powerful lobby, America's Health Insurance Plans (AHIP) said Medicare, too, would be cut and raise costs on millions of seniors. AHIP's members include some of the nation's largest health insurers, including Elevance Health, Humana, CVS Health's Aetna and an array of Blue Cross and Blue Shield plans. These health insurers, including UnitedHealth Group's UnitedHealthcare, provide health benefits to more than half of the nation's eligible seniors through privatized coverage known as Medicare Advantage. The plans contract with the federal government to provide traditional coverage available in traditional Medicare plus extra benefits and services to seniors, such as disease management and nurse help hotlines with some also offering vision, dental care and wellness programs. 'The President and Congressional leaders made a clear promise to seniors that there would be no cuts to Medicare as part of the budget reconciliation legislation," AHIP President and CEO Mike Tuffin said Monday. 'Last-minute attempts to cut Medicare Advantage to fund other priorities would directly undermine that promise and lead to higher costs and reductions in benefits for more than 34 million seniors,' Tuffin said. "We oppose cuts to Medicare Advantage, including the No UPCODE Act, and urge Congress to keep the promise to America's seniors.' Any loss in health plan members covered by Medicare Advantage would be an added blow to health insurers. They need large numbers of subscribers paying premiums to cover their costs. Many of these same health insurers have been hit hard by rising costs from an influx of seniors purchasing Medicare Advantage.
Medscape
6 days ago
- Business
- Medscape
Medicare Advantage Plans: Where's the Advantage?
Medicare Advantage (MA) plans entice many seniors with their simplicity and bundled coverage, offering an alternative to the complexity of traditional Medicare's separate Parts A, B, and D. When launched under the 1996 Balanced Budget Act as Medicare+Choice, they were intended to expand options and reduce costs for Medicare beneficiaries by inviting private insurers into the fold, but over time they have become a profit center for private interests at taxpayers' expense. Madelaine (Mattie) A. Feldman, MD Industry groups like AHIP insist that MA plans 'deliver better services, better access to care, and better value.' Yet, independent voices, such as the Center for Medicare Advocacy, point out that 'private plans were supposed to deliver better care more efficiently — and they have done neither.' The gap between marketing and reality is now too large to ignore. One of the biggest draws for MA plans, which have enrolled nearly 33 million Americans, is the cap on out-of-pocket costs. Unlike traditional Medicare, which covers only 80% of expenses and requires a separate Medigap policy for the rest, MA plans set a maximum annual limit on what enrollees pay (up to $9350 for in-network services in 2025). Monthly premiums for MA plans also tend to be lower, averaging $17 in 2025, and in some cases, there's no additional premium at all. The marketing is relentless: Seniors are bombarded with ads promising extra benefits like dental, vision, hearing, gym memberships, and even cash cards for everyday expenses. These commercials often paint a picture of comprehensive, affordable care that's hard to resist. However, many of these promises come with caveats. For instance, a plan might tout dental coverage but fail to mention the $160 annual cap, promote broad provider choice while restricting access to a narrow network of doctors and hospitals, or have directories that are out of date, listing physicians who are no longer in network. What's more, many of the most generous-sounding benefits are available only to specific groups, particularly those who are 'dual-eligible' for both Medicare and Medicaid. These beneficiaries are highly sought after by MA plans, not because they are sicker or need more help but because they bring in higher payments from the government, making them especially profitable for insurers. This raises an important question: Do MA plans truly deliver on their promises, or are they simply designed to attract the most lucrative enrollees? Here is how dual-eligible beneficiaries bring in more money: Higher reimbursement rates with profit margins outpacing costs Plans will often 'cherry pick' healthier beneficiaries. For example, Humana reported a 30% enrollment increase in dual-specific plans by marketing to younger, non-nursing home populations. Plans will inflate risk scores for the multiple chronic conditions that dual-eligible individuals often have. For example, coding "major depressive disorder" instead of "mild depression" adds about $2500/year per enrollee. Limited accountability for outcomes Only 5% of dual-eligible individuals are in fully integrated Medicare-Medicaid plans, allowing MA plans to avoid responsibility for long-term care costs, which are covered by Medicaid. Controversies and risks Care delays: 73% of MA prior authorization requests for dual-eligible individuals are initially denied, delaying biologics and specialty drugs. Taxpayer costs: Overpayments to MA plans for dual-eligible individuals contribute to Medicare's fiscal instability, raising Part B premiums for all beneficiaries. What the Ads Don't Tell You Unmet needs remain, even for 'extra' benefits. The Centers for Medicare & Medicaid Services (CMS) provides nearly $20 billion per year in rebates to MA plans to fund supplemental benefits, but many low-income MA enrollees still report unmet dental, vision, and hearing needs due to cost. The reality is that advertised benefits often come with low annual caps or limited provider networks, leaving many seniors unable to access or afford the care they were promised. Narrow networks limit your choice of doctors. Ads and brokers rarely mention that MA plans restrict which doctors and hospitals you can use. While traditional Medicare lets you see any provider who accepts Medicare (about 90% of US physicians), MA plans are notorious for 'narrow' networks. For example, a recent 'Network Adequacy' complaint to CMS described an MA plan in Florida that removed about 70% of rheumatologists in Palm Beach County from its network, leaving patients scrambling to find care. The Coalition of State Rheumatology Organizations (CSRO) has highlighted this and other growing problems in a recent webinar. Prior authorizations create delays and denials. Another major issue unique to MA plans is the widespread use of prior authorizations. According to AARP, over 90% of MA plans require prior authorization for services ranging from lab tests and procedures to hospital stays. For medications administered in the doctor's office (Part B drugs), 98% of MA plans require prior authorization. These hurdles often result in delays, denials, and extra administrative burden for both patients and providers, and they are not present in traditional Medicare. MA plans impose strict drug formularies and 'fail first' (step therapy) policies. In these policies, which are often placed especially on provider-administered medications, patients are often forced to try and fail on less effective or unaffordable drugs before getting the therapy their doctor originally recommended. These utilization management tools are not used in original Medicare. Rheumatologists across the country, as reported to the CSRO's Payer Issue Response Team, consistently encounter these obstacles, which delay or block access to needed care. Brokers have incentives to hide the risks of enrolling in MA plans. Seniors are often unaware that brokers earn higher commissions for enrolling them in MA plans than for signing them up for traditional Medicare with a supplement. Once enrolled in an MA plan, it can be difficult or expensive to switch back to traditional Medicare, as obtaining a Medigap plan may require medical underwriting — a barrier not present when enrolling in Medigap at the outset. Brokers rarely disclose these risks. Although CMS's 2025 Final Rule aimed to standardize and cap agent and broker compensation, lawsuits have delayed these changes, so strong financial incentives for brokers to steer seniors into MA plans remain in place. MedPAC's Assessment of MA Cost and Care Despite industry claims that MA plans save the government money, the independent Medicare Payment Advisory Commission (MedPAC) has repeatedly found the opposite. In its March 2025 report, MedPAC estimated that MA plans will cost the federal government $84 billion more in 2025 alone than if those same beneficiaries were enrolled in traditional fee-for-service Medicare — a 20% overpayment. These excess costs are driven mainly by two factors: 'coding intensity,' where MA plans document more diagnoses to increase risk scores and payments; and 'favorable selection,' meaning MA plans tend to enroll healthier individuals whose costs are lower than their risk scores suggest. MedPAC's analyses, echoed by other independent experts, show these overpayments have ranged from about $80 billion to as high as $140 billion per year. The commission also highlights that nearly half of MA enrollees face restricted provider networks, which can delay or limit access to care for complex conditions. For example, 68% of MA plans require prior authorization for rheumatology drugs, compared with 0% in traditional Medicare, leading to further barriers for patients. In summary, MedPAC does not view MA plans as a cost-saving success and continues to urge Congress to reform payment policies and address these structural imbalances. Profits Over Patients? MA's evolution into a system where profits often take precedence over patient care is starkly illustrated by the recent Department of Justice criminal investigation into UnitedHealth's Medicare Advantage business practices, which follows allegations of Medicare fraud and inflated risk coding. At the same time, rising care costs and increased scrutiny have led some insurers to scale back: Many plans are exiting markets, shrinking service areas, or reducing benefits to preserve profit margins. In 2025, 60% of MA plans weakened their benefit offerings, meaning enrollees get even less coverage than before. Unlike traditional Medicare, where benefits are stable and guaranteed, MA plans can and do reduce care to maintain their bottom line — leaving seniors with fewer choices and more barriers when they need care most. Greater scrutiny of insurers' business practices for MA plans appears to be on the way. CMS recently announced that it will immediately 'audit all eligible MA contracts for each payment year in all newly initiated audits and invest additional resources to expedite the completion of audits for payment years 2018 through 2024.' While not all MA plans are problematic, it appears that the significant issues seniors are already facing are likely to become increasingly more common in the future. If we are to preserve the original intent of this public-private partnership, we must institute some reforms: rigorous oversight, true accountability in health care decisions, and a renewed commitment to equity in care. Anything less risks turning Medicare Advantage's promise into little more than a marketing slogan, rather than the safety net our seniors deserve.
Globe and Mail
28-05-2025
- Business
- Globe and Mail
American Hotel Income Properties REIT LP Provides Update On Voting And Notes Adjustment To Its Management Information Circular
VANCOUVER, British Columbia, May 27, 2025 (GLOBE NEWSWIRE) -- American Hotel Income Properties REIT LP ('AHIP') (TSX: TSX: HOT.U, TSX: announces that due to the ongoing labour dispute between the Canadian Union of Postal Workers and Canada Post some unitholders may experience a delay in receiving the proxy-related materials for the annual and special meeting of unitholders scheduled to be held on June 26, 2025 (the "Meeting") and may not receive such materials prior to the Meeting. The Meeting materials have been filed under AHIP's profile on SEDAR+ and are available at as well as on the following page of AHIP's website: Unitholders will still be able to vote their units either directly by proxy (for registered unitholders) or indirectly through their intermediary (for beneficial unitholders who hold their units through brokerage firms or other intermediaries). Instructions respecting voting can be obtained as outlined below. If you are a registered unitholder, please contact Computershare Investor Services Inc. at 1-800-564-6253 to obtain your proxy form control number to cast your vote for the upcoming Meeting. If you hold units through an intermediary such as a brokerage firm, please contact your intermediary directly for a copy of the voting instruction form and assistance with voting. The deadline for voting by proxy for the Meeting is 11:00 a.m. (Pacific time) on June 24, 2025. AHIP is also advising unitholders of an adjustment to its Management Information Circular dated May 15, 2025 (the 'Circular') which has been mailed to unitholders for use in connection with the Meeting. On pages 22 and 44 of the Circular it was reported that as of May 15, 2025: (i) the total number of units reserved for issuance under the Amended and Restated Securities-Based Compensation Plan of AHIP dated May 11, 2022 (the 'SBC Plan') was 4,355,078, representing approximately 5.58% of the issued and outstanding units on a non-diluted basis, of which 2,155,078 (assuming the maximum payout of 200% on the restricted stock units ('RSUs') previously granted as performance awards which were outstanding on May 15, 2025) were full value awards and 2,200,000 were unit-options; and (ii) 3,452,191 units were eligible to be issued under the SBC Plan representing 4.42% of AHIP's issued and outstanding units on a non-diluted basis, of which 1,748,556 were eligible to be issued as full value awards, representing 2.24% of AHIP's issued and outstanding units on a non-diluted basis. When calculating such amounts certain of the previously issued RSUs granted as performance awards were included on the basis of an assumed 100% payout rather than the potential maximum payout of 200%. After adjusting for an assumed maximum payout of 200% for all RSUs previously issued as performance awards, as of May 15, 2025: (i) the total number of units reserved for issuance under the SBC Plan was 5,174,399, representing approximately 6.63% of the issued and outstanding units on a non-diluted basis, of which 3,024,399 (assuming the maximum payout of 200% on the RSUs previously granted as performance awards which were outstanding on May 15, 2025) were full value awards and 2,150,000 were unit-options; and (ii) 2,632,870 units were eligible to be issued under the SBC Plan representing 3.37% of AHIP's issued and outstanding units on a non-diluted basis, of which 879,235 were eligible to be issued as full value awards, representing 1.13% of AHIP's issued and outstanding Units on a non-diluted basis. American Hotel Income Properties REIT LP (TSX: TSX: HOT.U, TSX: or AHIP, is a limited partnership formed to invest in hotel real estate properties across the United States. AHIP's portfolio of premium branded, select-service hotels are located in secondary metropolitan markets that benefit from diverse and stable demand. AHIP hotels operate under brands affiliated with Marriott, Hilton, IHG and Choice Hotels through license agreements. AHIP's long-term objectives are to increase the value of its hotel properties through operating excellence, active asset management and value-adding capital expenditures and increase unitholder value and distributions to unitholders. More information is available at
Yahoo
28-05-2025
- Business
- Yahoo
American Hotel Income Properties REIT LP Provides Update On Voting And Notes Adjustment To Its Management Information Circular
VANCOUVER, British Columbia, May 27, 2025 (GLOBE NEWSWIRE) -- American Hotel Income Properties REIT LP ('AHIP') (TSX: TSX: HOT.U, TSX: announces that due to the ongoing labour dispute between the Canadian Union of Postal Workers and Canada Post some unitholders may experience a delay in receiving the proxy-related materials for the annual and special meeting of unitholders scheduled to be held on June 26, 2025 (the "Meeting") and may not receive such materials prior to the Meeting. The Meeting materials have been filed under AHIP's profile on SEDAR+ and are available at as well as on the following page of AHIP's website: Unitholders will still be able to vote their units either directly by proxy (for registered unitholders) or indirectly through their intermediary (for beneficial unitholders who hold their units through brokerage firms or other intermediaries). Instructions respecting voting can be obtained as outlined below. If you are a registered unitholder, please contact Computershare Investor Services Inc. at 1-800-564-6253 to obtain your proxy form control number to cast your vote for the upcoming Meeting. If you hold units through an intermediary such as a brokerage firm, please contact your intermediary directly for a copy of the voting instruction form and assistance with voting. The deadline for voting by proxy for the Meeting is 11:00 a.m. (Pacific time) on June 24, 2025. AHIP is also advising unitholders of an adjustment to its Management Information Circular dated May 15, 2025 (the 'Circular') which has been mailed to unitholders for use in connection with the Meeting. On pages 22 and 44 of the Circular it was reported that as of May 15, 2025: (i) the total number of units reserved for issuance under the Amended and Restated Securities-Based Compensation Plan of AHIP dated May 11, 2022 (the 'SBC Plan') was 4,355,078, representing approximately 5.58% of the issued and outstanding units on a non-diluted basis, of which 2,155,078 (assuming the maximum payout of 200% on the restricted stock units ('RSUs') previously granted as performance awards which were outstanding on May 15, 2025) were full value awards and 2,200,000 were unit-options; and (ii) 3,452,191 units were eligible to be issued under the SBC Plan representing 4.42% of AHIP's issued and outstanding units on a non-diluted basis, of which 1,748,556 were eligible to be issued as full value awards, representing 2.24% of AHIP's issued and outstanding units on a non-diluted basis. When calculating such amounts certain of the previously issued RSUs granted as performance awards were included on the basis of an assumed 100% payout rather than the potential maximum payout of 200%. After adjusting for an assumed maximum payout of 200% for all RSUs previously issued as performance awards, as of May 15, 2025: (i) the total number of units reserved for issuance under the SBC Plan was 5,174,399, representing approximately 6.63% of the issued and outstanding units on a non-diluted basis, of which 3,024,399 (assuming the maximum payout of 200% on the RSUs previously granted as performance awards which were outstanding on May 15, 2025) were full value awards and 2,150,000 were unit-options; and (ii) 2,632,870 units were eligible to be issued under the SBC Plan representing 3.37% of AHIP's issued and outstanding units on a non-diluted basis, of which 879,235 were eligible to be issued as full value awards, representing 1.13% of AHIP's issued and outstanding Units on a non-diluted basis. ABOUT AMERICAN HOTEL INCOME PROPERTIES REIT LP American Hotel Income Properties REIT LP (TSX: TSX: HOT.U, TSX: or AHIP, is a limited partnership formed to invest in hotel real estate properties across the United States. AHIP's portfolio of premium branded, select-service hotels are located in secondary metropolitan markets that benefit from diverse and stable demand. AHIP hotels operate under brands affiliated with Marriott, Hilton, IHG and Choice Hotels through license agreements. AHIP's long-term objectives are to increase the value of its hotel properties through operating excellence, active asset management and value-adding capital expenditures and increase unitholder value and distributions to unitholders. More information is available at For additional information, please contact: Investor Relationsir@
Yahoo
28-05-2025
- Business
- Yahoo
American Hotel Income Properties REIT LP Provides Update On Voting And Notes Adjustment To Its Management Information Circular
VANCOUVER, British Columbia, May 27, 2025 (GLOBE NEWSWIRE) -- American Hotel Income Properties REIT LP ('AHIP') (TSX: TSX: HOT.U, TSX: announces that due to the ongoing labour dispute between the Canadian Union of Postal Workers and Canada Post some unitholders may experience a delay in receiving the proxy-related materials for the annual and special meeting of unitholders scheduled to be held on June 26, 2025 (the "Meeting") and may not receive such materials prior to the Meeting. The Meeting materials have been filed under AHIP's profile on SEDAR+ and are available at as well as on the following page of AHIP's website: Unitholders will still be able to vote their units either directly by proxy (for registered unitholders) or indirectly through their intermediary (for beneficial unitholders who hold their units through brokerage firms or other intermediaries). Instructions respecting voting can be obtained as outlined below. If you are a registered unitholder, please contact Computershare Investor Services Inc. at 1-800-564-6253 to obtain your proxy form control number to cast your vote for the upcoming Meeting. If you hold units through an intermediary such as a brokerage firm, please contact your intermediary directly for a copy of the voting instruction form and assistance with voting. The deadline for voting by proxy for the Meeting is 11:00 a.m. (Pacific time) on June 24, 2025. AHIP is also advising unitholders of an adjustment to its Management Information Circular dated May 15, 2025 (the 'Circular') which has been mailed to unitholders for use in connection with the Meeting. On pages 22 and 44 of the Circular it was reported that as of May 15, 2025: (i) the total number of units reserved for issuance under the Amended and Restated Securities-Based Compensation Plan of AHIP dated May 11, 2022 (the 'SBC Plan') was 4,355,078, representing approximately 5.58% of the issued and outstanding units on a non-diluted basis, of which 2,155,078 (assuming the maximum payout of 200% on the restricted stock units ('RSUs') previously granted as performance awards which were outstanding on May 15, 2025) were full value awards and 2,200,000 were unit-options; and (ii) 3,452,191 units were eligible to be issued under the SBC Plan representing 4.42% of AHIP's issued and outstanding units on a non-diluted basis, of which 1,748,556 were eligible to be issued as full value awards, representing 2.24% of AHIP's issued and outstanding units on a non-diluted basis. When calculating such amounts certain of the previously issued RSUs granted as performance awards were included on the basis of an assumed 100% payout rather than the potential maximum payout of 200%. After adjusting for an assumed maximum payout of 200% for all RSUs previously issued as performance awards, as of May 15, 2025: (i) the total number of units reserved for issuance under the SBC Plan was 5,174,399, representing approximately 6.63% of the issued and outstanding units on a non-diluted basis, of which 3,024,399 (assuming the maximum payout of 200% on the RSUs previously granted as performance awards which were outstanding on May 15, 2025) were full value awards and 2,150,000 were unit-options; and (ii) 2,632,870 units were eligible to be issued under the SBC Plan representing 3.37% of AHIP's issued and outstanding units on a non-diluted basis, of which 879,235 were eligible to be issued as full value awards, representing 1.13% of AHIP's issued and outstanding Units on a non-diluted basis. ABOUT AMERICAN HOTEL INCOME PROPERTIES REIT LP American Hotel Income Properties REIT LP (TSX: TSX: HOT.U, TSX: or AHIP, is a limited partnership formed to invest in hotel real estate properties across the United States. AHIP's portfolio of premium branded, select-service hotels are located in secondary metropolitan markets that benefit from diverse and stable demand. AHIP hotels operate under brands affiliated with Marriott, Hilton, IHG and Choice Hotels through license agreements. AHIP's long-term objectives are to increase the value of its hotel properties through operating excellence, active asset management and value-adding capital expenditures and increase unitholder value and distributions to unitholders. More information is available at For additional information, please contact: Investor Relationsir@ in retrieving data Sign in to access your portfolio Error in retrieving data Error in retrieving data Error in retrieving data Error in retrieving data
