Showing posts with label Medicare for all. Show all posts
Showing posts with label Medicare for all. Show all posts

Sunday, November 13, 2022

Save Our Healthcare - Nov. 13, 2022 Town Hall - register here - http://tinyurl.com/HealthCareTH

Last week Retiree Advocate had 250 people, mostly retirees. This is run by MORE which should bring working teachers to the table as we fight the Mulgrew attempt to divide (and blame) retirees for fighting back.

If you missed last week, here is a link: https://youtu.be/yNwIWMOWig4

 

I copied this notice from Jonathan - don't expect royalties.

https://jd2718.org/

MORE Town Hall

Sunday evening, November 13

http://tinyurl.com/HealthCareTH

The fight against amending NYC Administrative Code 12-126 continues. The code sets a floor the city must pay for our healthcare, and blocks them from going lower.

The amendment will let them go lower. We need to defeat this amendment, or even stop City Council from considering it.

http://tinyurl.com/HealthCareTH

This event is for current teachers and other school workers, and for retirees.

These changes threaten the healthcare of IN SERVICE and RETIREES. We are in this together. We will beat this together.

See you Sunday!

 

Friday, November 4, 2022

Exposing the Adams/Mulgrew Threat to Our Healthcare: Untangling the Confusion- Retiree Advocate - Sunday Nov. 6 7PM

#Mulgrewcare run amuck - stop the madness!!!!

Here is the video and link:
 
 
 
Retiree Advocate is doing a zoom on Sunday Nov. 6 7PM to address questions people may have and to expose the confusion created by the the joint operation of the city and some of the unions, led by Mulgrew in the UFT and DC 37, the largest components who dominate the MLC (Metropolitan Labor Committee) who make deals with the city that control our health care. We may not have all the answers but we have some answers. We are hoping to have Marianne Pizzitola join us but if she can't  make it we have some knowledgeable people.

MORE is planning another zoom in the same issue a week later at the same time and Marianne is definitely going to be there.
 

 

Exposing the Adams/Mulgrew Threat to Our Healthcare: Untangling the Confusion


This Sunday, Nov 6 at 7PM, Retiree Advocate/UFT is holding a Zoom Info Meeting to share what we know - and what we don't know - regarding the current healthcare crisis in our unions. 

Learn what role Mulgrew and other union leaders in the MLC have been playing in partnership with Mayor Adams and the Office of Labor Relations.


New information is coming in constantly and we are trying to stay up to date. This meeting will share info & analysis, and try to answer your questions.


  Register Here

Attendance will be limited to 100.  Meeting will be  recorded for those who cannot make it.



Here are some comments I gleaned from some of the listserve discussions after a district rep sent out an appeal to chapter leaders to get their staffs to call the city council to change the admin code. As Jonathan says in his current blog:  Administrative Code 12-126 – Line by line:

The code today means:

“The City pays an amount equal to the cost of HIP”

The code if the Mulgrew/Nespoli/Adams amendment goes through will say:

The City pays the cost of HIP, and no more than that, or else some other amount – and that amount could be different for different groups of city workers, and there is no limit on how low those amounts might be.

When you call your city council member, please explain this to them as you urge them to protect workers and retirees, and reject the amendment.

 
Comments from RA listserve:
 
It's pure pap! All one has to do is read the amendment language. Your DR is asking you to not believe your own eyes or use your own brain. The amendment reaffirms nothing because Judge Frank's ruling changed absolutely nothing. His ruling merely said that retirees are protected from paying premiums, specifically on the now-dormant Medicare Advantage Plus plan, because of price protections built into the city code.

It's not hard to understand the amendment. Just look at it. It does two things and two things only: First it strips healthcare price protections, for ALL current and retired municipal employees, by yanking those protections out of city law, and placing them in the hands of OLR lawyers and union bosses. Second, it allows city bureaucrats to classify municipal employees into separate, as yet undefined, categories. That's a prospect that begs the creation of tiered, unequal levels of coverage for past and present city workers.

I bet your DR wouldn't wish that on her mother's health plan!
 
, or in the alternative,
This means, "What was said before this doesn't count."

 in the case of any class of individuals eligible for coverage by a plan jointly agreed upon by the city and the municipal labor committee to be a benchmark plan for such class,
 
This means, "For anyone and everyone in city employment, the benchmark price - formerly established as the cost of the HIP-HMO plan, and until now protected by this law - can now be chosen by the MLC and OLR. We don't need no stinkin' law, made by stinkin' elected legislators, to tell us what to do! And if we want to, we can have multiple plans, and multiple benchmark prices, for multiple classes of people, and we can change that any time we like. So there!"

not to exceed the full cost of such benchmark plan as applied to such class. 
This means, "When we say your brand new benchmark plan costs only ten bucks, but you want to stay in your old plan; the one that costs five hundred bucks - and that we will still offer because we believe in freedom of choice - no problem! Just cough up the $490. But hey, if you want, you can have our super-duper $5 or $8 plan for free! Because, you know, choice!" 
 
And some Media links to articles: 
 
An excellent article below from Work-Bites

Beware of the Mad Dash to Medicare Advantage

And one more:


The City Council must enable budget-cutting new health insurance options for retirees, warns Eric Adams’s chief labor negotiator — or City Hall will eliminate existing insurance plans

Thursday, November 3, 2022

Saturday Night Massacre - Behind Mulgrew's Letter to members on #Mulgrewcare - More Lies and Obfuscation

We're all in the same boat, we've painstakingly carved out a hole in it, and we're sinking fast. Leadership had better wake up some time before we hit bottom... Arthur Goldstein, NYC Educator

Just about everything the UFT sends to members on healthcare givebacks is easy to debunk. The only debate seems to be whether the UFT is sending out misinformation or disinformation (intentional bs). The UFT wants you to lobby the City Council to change Administrative Code 12-126 (City law). Let's try to get down to the basics of what that means.... James Eterno, ICE blog: DO YOU BELIEVE CITY EMPLOYEES AND RETIREES WILL GET BETTER HEALTHCARE IF THE CITY PAYS LESS FOR HEALTHCARE?

 

Thursday, Nov. 3, 2022

Where do I begin? Today I am focusing on the threatening email Mulgrew sent out Saturday. I wrote about it:

Unity probably thinks Mulgrew hit a home run - an LOL moment
Some thinking inside the Unity machine is this was a brilliant move to get the rank and file involved in pushing their case by threatening working teachers with a $1500 healthcare payment each year and urging them to call their city council, a scheme cooked up by both Adams and Mulgrew and a few other union leaders to bully their way through. 
 
Originally, they thought they had an easy path in the city council to getting their way without scaring the membership. The internal lobbying was not effective, while those of us opposed to the reduction in healthcare were having an impact as our rally last Thursday showed.

So Saturday Mulgrew, seeing a loss coming at his attempt to get the council to change the Admin code in ways that would relieve the city obligation to pay up to a rate agreed to in the 60s, in desperation he tried a scare tactic with the working members, claiming Adams will force working UFT members to pay $1500 a year for healthcare. 
 
What his email accomplished was waking the membership up to the healthcare crisis the UFT is facing and created confusion and uncertaintly and opened the door to other voices. Sometimes we have been screaming into the wind. Already there are signs people are not just listening to the UFT line. 
 
James Eterno took this one on:
What Mulgrew obfuscated about was trying to give the impression Adams can do this unilaterally when in fact Mulgrew must agree to any changes. Again Jame exposes the Mulgrew lie:
James includes links to the MLC agreement with the city that requires both sides to agree and the video above of the increasingly famous Mulgrew critic Marianne Pizzitola.

I was on a zoom with people from MORE last night where Marianne filled in these younger working teachers on the real deal. There will be a town hall on Sunday Nov. 14 at 7PM to spread the word with Marianne answering questions.

Retiree Advocate is also working on a town hall with Marianne this Sunday at 7PM aimed at retirees.

There are so many great bloggers out there exposing the UFT/Unity Caucus/Mulgrew Shakespearean dramedy. Rather than repeat or echo these blogs here are some links.
 
Mulgrew's savings are our costs 
Everytime Mulgrew says "savings" think "out of your pocket"

 
Jonathan Halabi hits a few more home runs -  
  • ABCs of Mulgrew vs. Retirees’ health care.  
  • Quiz: Health care cuts? or Health care savings? : You are experiencing pain, and think about going to the emergency room, but think about the cost (copay jumped several years ago from $50 to $150) and decide that it’s probably not serious, and take tylenol instead. Cost or Savings? You are getting less health care than you would have. The cost scared you away. That is a cut, right? Less care? But you might have said that’s a savings: if you are Mulgrew, Nespoli, Adams, or an Insurance Executive. That’s an emergency room visit that you might have had to pay for, and now you didn’t. High fives for jacking up copays! (I was in this situation, but I went to the ER. That triple-digit copay was a cost to me, a savings to Mulgrew.)  
Jonathan also points out that more "savings" come out of the need for

Approval for a procedure that should not need approval

Because of a family history of cancer, you need a special diagnostic procedure every year. But this year a guy who works for an insurance company calls to say that your procedure has been approved. Cost or Savings? If you are a regular person, neither. You need the test, you will get it. But if you are Michael, Harry, Eric or a stockholder in Emblem or Aetna or Alliance of whatever monster insurance company is involved, that’s a savings.

When Jonathan blogs, UFT leadership listens - and looks to counter.

Arthur Goldstein, the dean of ed bloggers, comes back with another powerful hit on the UFT leadership: UFT Leadership's Contract Plan

Can you even believe we're battling to change a law so NYC can charge premiums? If Mulgrew and Adams succeed in making retired couples pay 5K a year for the health care they were promised for free their entire careers, who's to say it will stop there? If Adams doesn't get to charge in-service members $1500 a year for GHI now, who can say he won't charge them 2500 next year? After all, in service members might be able to afford it better than retired members. Can't you imagine Adams making that argument? Can you imagine us supporting it? This, of course, is all administered by the MLC. We're the largest union in the city, and the largest voice in the MLC. Meanwhile, the DOE sees us actively campaigning for worse conditions.
Arthur connects the Mulgrew/Adams partnership on health care to the upcoming contract. Why will we get a contract when Adams can just make outrageous demands and stall/Bloomberg us for years?

More "savings" - for the city - will be coming with further and higher co-pays and for those with chronic illness - a massive healthcare hit.

Oh, and if you are still working and looking at being in Medicare when you turn 65 - the Mulgrew plan will help kill Medicare as a public option - they brag about draining $600 million out of Medicare and into the hands of the private insurers.

What is the way out? There may be no way out especially with Mulgrew in charge. Call me a dreamer but if we had a medicare for all even at the NYS level, that would be a way out. But given the real probability (even I'm sick of Democrats) Hochul will lose, look for bad times ahead.


Sunday, October 30, 2022

Outrage Grows at Mulgrew Healthcare Blackmail pitting working members ($1500 a year) against retirees (forced MedAdv) - Beats Putin to Use of Nuclear Option -

We deserve better from our leadership. ...There is no victory in that email. It's the job of leadership to better our lot, not march us off a cliff. MLC and UFT leadership need to work toward a better solution, or stand down for someone who will..... Arthur Goldstein, NYC Educator
These are pretty bold words from Arthur (I post his entire brilliant blog post below), who supported the leadership and ran on the Unity slate in the election last May. Not a good sign for Mulgrew. I also got a call from an active Unity Caucus member who was not happy either. Also not a good sign for Mulgrew as Unity frays a bit at the edges. Some insiders also not happy with the increasing ineptitude.
 
Sunday, October 30, 2022 - Erev Halloween
 
The municipal union healthcare issue blew up Saturday evening as news of Mulgrew's outrageous threats (see below) of an either or: working UFT members will pay a $1500 yearly healthcare premium or retirees will be forced into Medicare advantage like it or not with no opt out choice. A few choice comments:
What a scam this is - the unions and the mayor have come up with this piece of blackmail to get everyone on board to pass the bill before the city council. The UFT has no limit to their perfidy. ... UFT Retiree - Brooklyn 

The nuclear option is invoked! It's retirees versus in-service employees! Tell the City Council to pass the amendment! Let us screw you over so we can all be protected from Mulgrew's criminally negligent incompetence: The shitty deal he agreed to in 2018! It's a dystopian nightmare.... UFT Retiree
The Mulgrew letter reads as an ultimatum from the city, as if the union reps on the MLC have no option to say NO. James points out that it's all bullshit because 1992 MLC CITY AGREEMENT SAYS MLC UNIONS MUST AGREE TO HEALTHCARE GIVEBACKS

Interpret "must" as there can be no changes UNLESS they agree --

It is understood and agreed that the parties will continue to bargain over and determine by mutual agreement the terms and conditions of employee health benefits.

"Determine by mutual agreement" is strong language that prohibits the City from unilaterally changing anything. It looks like Mulgrew's sole motive in changing the Administrative Code is to save the City money on our backs with givebacks on healthcare. Any change would also do away with our contractual right in Article 3G1 to a choice of premium free healthcare plans..... ICEUFT Blog, MULGREW'S LATEST EMAIL ASKS IF WE WANT HEALTHCARE GIVEBACKS FOR RETIREES OR ACTIVE MEMBERS

Unfortunately MLC and the city are partners so expect MLC to agree to something no matter what Mulgrew is saying about resisting. UFT members have no representation at the MLC while Mayor Adams has the key unions on his side. He is putting his eggs inside changing the admin code which would allow the city to offer retirees the opting of spending $5k a year extra per couple to keep what we have.

Tuesday, October 11, 2022

Oct. 12 12:15 PM - Marianne and MulgrewCare Truck at Two Must Show Healthcare Rallies Wednesday - City Council and Delegate Assembly -Turnout numbers count

If you are a retiree, tomorrow is the day for you to show up and be counted at one or both events.
 
The city council will be voting soon on the future of your health care. Tomorrow  12:15, press conference around 1 at City Hall, followed at 3:30 a few blocks away at 52 Broadway where we show numbers to Mulgrew and crew. Keep the pressure on both the politicians and UFT leadership.
 
For working UFT members, this is the first delegate assembly of the year. Show Mulgrew you won't accept healthcare cuts.
 
Reports are coming in on new deductibles and co-pays. If we are silent it will only get worse.
Norm

Tuesday, Oct. 11, 2022

I posted yesterday about the two rallies coming up on Wednesday:

Rally Wednesday Oct. 12 Protest Changes in NYC Admin Code as NYC Firefighters Union Push New York City Council to Stop Messing with Retirees’ Healthcare

We hear the big screen truck will be joining us with Mulgrew videos following us downtown on Broadway. We have sound and speakers -  and Marianne Pizzitola will speak at both rallies - a bunch of UFT war horses met with her on zoom last week to fill her in on how the UFT operates. Her videos below are a sample.

Here is a new leaflet focused on the DA.

Here is the posting by The NYC Organization of Public Service Retirees

NYC Employee & Retiree Benefits at risk

 

Monday, October 10, 2022

Rally Wednesday Oct. 12 Protest Changes in NYC Admin Code as NYC Firefighters Union Push New York City Council to Stop Messing with Retirees’ Healthcare

We are asking everyone who cherishes the healthcare benefits they earned to come to City Hall and let the City Council hear and see you!   Urge them NOT TO CHANGE Administrative Code 12-126 and protect us from those urging changes to a law that has protected us since 1967. We then will head down the block to UFT HQ and tell Michael Mulgrew of the UFT to keep his hands off our benefits and stop selling them for his own wages!  ....

The NYC Organization of Public Service Retirees

Here is the RALLY INFO FLYER    AND THE ISSUE FACT SHEET
 
This is a joint rally with CROC- Cross Union Organizing Committee, along with Retiree Advocate, groups that have been leading the way in the battle.
 
The Court stated that the City could not force retirees into paying an extra $191 per month if they wanted to opt out of an inferior privatized Medicare Advantage Plan they were being forced into. Since the victory was based on the NYC Administrative Code, the city is now doing an end run by trying to get the Council to change the law!
 
And our own UFT leadership is leading the way by working with the city to mess with our health plans. 
 

 
The more unions that push back the better.
 

Bravest Push New York City Council to Stop Messing with Retirees’ Healthcare

“We have a lot of retirees that are calling that are confused as to why there is a need for a law change. They are against any of these changes.” — UFA President Andy Ansbro. Photo courtesy of FDNY

By Bob Hennelly

A split within the Municipal Labor Committee over the future of the healthcare coverage for New York City’s 250,000 municipal retirees is playing out behind the scenes at the City Council over a controversial MLC proposal to change the city’s Administrative Code 12-126 that requires the City Council’s  approval. 

The MLC is the umbrella organization for scores of unions that represent over 300,000 municipal workers. The change, which would alter the existing language covering healthcare for retirees, is also supported by the city’s Office of Labor Relations and the Adams administration.

The controversy is an outgrowth of last year’s successful retiree revolt against then-Mayor Bill de Blasio and the Municipal Labor Committee’s proposal to shift retirees to a privatized Medicare Advantage program in hopes of realizing some savings.

City Hall and the MLC said the plan, branded as Retiree Health Alliance, which was going to be run by Anthem and Empire Blue Cross Blue Shield, would produce $600 million in savings with no degradation in coverage. Retired civil servants and the NYC Organization of Public Service Retirees  countered the change threatened retirees’ continuity of care, would cost more and would cover less.

Tens of thousands of city retirees opted out. One key issue was a requirement that city retirees who opted out of the new offering would have to pay a $191 monthly premium for their old plan. Subsequently,  the two health insurance companies fronting the controversial plan withdrew. 

The New York City Organization of Public Service Retirees successfully challenged  the city in court bringing the implementation of the plan to a standstill at the start of the Adam’s administration. That litigation continues. 

In his decision, Judge Lyle Frank, ruled that thanks to the city’s Administrative Code 12-126, on the books since the 1960s, the city was obliged to continue providing retirees with their healthcare without charging them a premium.

Marianne Pizzitola is a retired FDNY EMT and was a member of DC 37’s Local 2507. Pizzitola is also the president of the New York City Organization of Public Service Retirees. In a Sept. 24 op-ed in the Daily News she praised the city’s existing administrative code that guaranteed “the city would pay for a choice of health insurance plans—up to a defined dollar cap. For 55 years, every teacher, firefighter, police officer, nurse and others who served the city knew  they would have access to a health insurance plan that met their families’ needs.”

Last month, the MLC voted to ask the City Council to alter the Administrative Code 12-126 as requested by the city’s Office of Labor Relations to clear the way for the implementation of a Medicare Advantage program.

The vote was not unanimous. 

Though the MLC’s largest unions like District Council 37, the United Federation of Teachers, Teamsters Local 831 (Uniformed Sanitation-men’s Association) support the change, several unions opposed it, including the Uniformed Fire Officers Association and the Uniformed Firefighters Association. 

In a Sept. 9 letter to his members, James Davis, president of the Professional Staff Congress explained why his union opposed the change.

“The proposed change eliminates the HIP-HMO rate as the single standard for determining the City’s obligation to pay for health insurance for city employees, retirees and their dependents,” explained Davis. “Under current law, the city is required to ‘pay the entire cost of health insurance coverage for city employees, city retirees, and their dependents, not to exceed one hundred percent of the full cost of HIP-HMO…’ (NYC Administrative Code, section 12-1260.)

Harry Nespoli, chair of the MLC and the president of Teamsters Local 831 did not return a call seeking comment. 

Retirees who oppose the shift to a Medicare Advantage plan point to a recent study by the Department of Health and Human Services Inspector General  that found the plans run by for profit providers showed that the “plans  sometimes denied or delayed patients’ access to medically necessary services, even though the requests met Medicare coverage rules.”

“We have a lot of retirees that are calling that are confused as to why there is a need for a law change. They are against any of these changes,” UFA President Andy Ansbro said during a phone interview.  “They want to keep their healthcare plan the way it is and they have reached out to us demanding that we get in front of this and we have explained to them that we have been a no vote on this change and at this point it is in the City Council’s hands and if they wish to make their voice heard they have to call their City Council member and speak to them and we ask that they speak with them respectfully but just get your point across you don’t believe this law should, be changed.”

 Ansbro continued. “The down side is we don’t know what the long term consequences are. We understand the short term consequences if they feel they will be able to make their Medicare Advantage Plan legal but if the courts rule that what you are trying to do is illegal, trying to change the law is not the way to go about it. You should go back to the drawing board and come up with a plan that’s actually legal.”

“The UFOA voted no in the MLC Steering committee and again voted NO in the general membership meeting,” wrote FDNY Lieut. James McCarthy in a text. “The fight against the change in the administrative code continues on the the City Council. Our active and retired members will also be expressing their opposition to the City Council.”

“The changes proposed would allow New York City, with the approval of the majority of the MLC, to create different classes of employees in reference to health insurance,” warned a UFOA blast email to all of its members and retirees. “This change would then allow New York City to give different health insurance plans to each class. The proposal will also remove HIP HMO as the benchmark for establishing the rate that the city must pay to maintain premium free healthcare for all active and retired members. This seismic change in language MUST BE STOPPED!”

The UFOA continued. “How did we get here…. Over a year ago NYC rolled out the option of Medicare Advantage and described it as a mirror of the current Senior Care Plan. The reality was our members' benefits and access to healthcare would be diminished. Multiple lawsuits were filed, and the rollout of Medicare Advantage was delayed by the judge’s ruling. The City has appealed, and the case will be heard in October. As a result of this pending decision, the city has chosen to change the Administrative Code.”

State Senator Gustavo Rivera, chair of the Senate Health Committee, is a one of the lead sponsors of the New York Health Act which calls for establishing a single payer healthcare system that would decouple healthcare coverage from employment.

“We are at a moment where we have to take all the realities that are around us and think about how we actually solve the problems that are before us,” Rivera said. “Committing ourselves by doubling down on a system that has insurance companies at its core is exactly the wrong direction to go in. But this is exactly what’s happening with the city shifting retirees' benefits for the sake of ‘saving money’—when what you are really doing is taking away the benefits that were negotiated  for the folks that are retirees. What I am telling these retirees and everybody else, is that healthcare is a right and we should act like it.”

 

Saturday, October 8, 2022

UFT Leaders complicit in Medicare fraud? Med Part C is MedAdv - massive fraud as per NYT - How Insurers Exploited Medicare for Billions

“Medicare Advantage overpayments are a political third rail,” said Dr. Richard Gilfillan, a former hospital and insurance executive and a former top regulator at Medicare, in an email. “The big health care plans know it’s wrong, and they know how to fix it, but they’re making too much money to stop. NYT

Medicare for all would put all these scam artists out of business - why does the UFT support these crooks?

Mulgrew continuously whines about health care costs but the policies he espouses contributes to these costs.

One of these cited for defrauding the Medicare system will be a partner to the MLC in any new plan offered by the city for retirees. Let us point out that these same groups control the 20% senior plan for retirees but they ability to defraud is somewhat limited by Medicare rules. 

And the entire working membership is under the

On Monday night at the Ex Bd Vinnie Gaglione declared MedAdv was just Medicare - Part C - in essence what's the big deal with it?

Mulgrew in essence is fine with the fraud issue -- he even said we can get more money out of Medicare.
 
My own docs have told me about upcoding - say you are overweight and they have access to the records -- they now ask Medicare for more money for care that has nothing to do with how much you weigh.
 
Is it time to accuse the UFT leadership of joining the fraud game?
Norm


The Cash Monster Was Insatiable’: How Insurers Exploited Medicare for Billions

By next year, half of Medicare beneficiaries will have a private Medicare Advantage plan. Most large insurers in the program have been accused in court of fraud.

Reed Abelson and

The health system Kaiser Permanente called doctors in during lunch and after work and urged them to add additional illnesses to the medical records of patients they hadn’t seen in weeks. Doctors who found enough new diagnoses could earn bottles of Champagne, or a bonus in their paycheck.

Anthem, a large insurer now called Elevance Health, paid more to doctors who said their patients were sicker. And executives at UnitedHealth Group, the country’s largest insurer, told their workers to mine old medical records for more illnesses — and when they couldn’t find enough, sent them back to try again.

Each of the strategies — which were described by the Justice Department in lawsuits against the companies — led to diagnoses of serious diseases that might have never existed. But the diagnoses had a lucrative side effect: They let the insurers collect more money from the federal government’s Medicare Advantage program.

Medicare Advantage, a private-sector alternative to traditional Medicare, was designed by Congress two decades ago to encourage health insurers to find innovative ways to provide better care at lower cost. If trends hold, by next year, more than half of Medicare recipients will be in a private plan.

Soon, Half of Medicare Will be Privatized

Medicare Advantage is on track to enroll most Medicare beneficiaries by next year.

But a New York Times review of dozens of fraud lawsuits, inspector general audits and investigations by watchdogs shows how major health insurers exploited the program to inflate their profits by billions of dollars.

The government pays Medicare Advantage insurers a set amount for each person who enrolls, with higher rates for sicker patients. And the insurers, among the largest and most prosperous American companies, have developed elaborate systems to make their patients appear as sick as possible, often without providing additional treatment, according to the lawsuits.

As a result, a program devised to help lower health care spending has instead become substantially more costly than the traditional government program it was meant to improve.

Eight of the 10 biggest Medicare Advantage insurers — representing more than two-thirds of the market — have submitted inflated bills, according to the federal audits. And four of the five largest players — UnitedHealth, Humana, Elevance and Kaiser — have faced federal lawsuits alleging that efforts to overdiagnose their customers crossed the line into fraud.

The fifth company, CVS Health, which owns Aetna, told investors its practices were being investigated by the Department of Justice.

In statements, most of the insurers disputed the allegations in the lawsuits and said the federal audits were flawed. They said their aim in documenting more conditions was to improve care by accurately describing their patients’ health.

Many of the accusations reflect missing documentation rather than any willful attempt to inflate diagnoses, said Mark Hamelburg, an executive at AHIP, an industry trade group. “Professionals can look at the same medical record in different ways,” he said.

The government now spends nearly as much on Medicare Advantage’s 29 million beneficiaries as on the Army and Navy combined. It’s enough money that even a small increase in the average patient’s bill adds up: The additional diagnoses led to $12 billion in overpayments in 2020, according to an estimate from the group that advises Medicare on payment policies — enough to cover hearing and vision care for every American over 65.

Another estimate, from a former top government health official, suggested the overpayments in 2020 were double that, more than $25 billion.

The increased privatization has come as Medicare’s finances have been strained by the aging of baby boomers. But for insurers that already dominate health care for workers, the program is strikingly lucrative: A study from the Kaiser Family Foundation, a research group unaffiliated with the insurer Kaiser, found the companies typically earn twice as much gross profit from their Medicare Advantage plans as from other types of insurance.

Matthew Wiggin, a spokesman for the company, called the inspector general’s report “misleading.” He said the company uses diagnostic coding to improve patient care, and noted that the whistle-blower in the lawsuit had not worked for the company in nearly a decade. “Our chart review process complies with regulatory standards,” he said, adding, “Our robust compliance program also proactively seeks to identify fraud, waste and abuse in the system.”

The company countered by suing Medicare, arguing that it wasn’t required to fix inaccurate records before regulations changed in 2014. It won at first, then lost on appeal. In June, the Supreme Court declined to hear the case.

Even before the first lawsuits were filed, regulators and government watchdogs could see the number of profitable diagnoses escalating. But Medicare has done little to tamp down overcharging.

Several experts, including Medicare’s advisory commission, have recommended reducing all the plans’ payments. Congress has ordered several rounds of cuts and gave C.M.S. the power to make additional reductions if the plans continued to overbill. The agency has not exercised that power.

The agency does periodically audit insurers by looking at a few hundred of their customers’ cases. But insurers are fined for billing mistakes found only in those specific patients. A rule proposed during the Trump administration to extrapolate the fines to the rest of the plan’s customers has not been finalized.

Some of the agency’s top leaders have had close ties to industry. Marilyn Tavenner, a former C.M.S. administrator, left in 2015, then ran the main trade group for health insurers; she was replaced by Andy Slavitt, a former executive at UnitedHealth. Jonathan Blum, the agency’s current chief operating officer, worked for an insurer after leaving the agency in 2014, then became an industry consultant, before returning to Medicare last year.

Ted Doolittle, who served as a senior official for the agency’s Center for Program Integrity from 2011 to 2014, said officials at Medicare seemed uninterested in confronting the industry over these practices. “It was clear that there was some resistance coming from inside” the agency, he said. “There was foot dragging.”

There are signs the problem is continuing.

“We are hearing about it more and more,” said Jacqualine Reid, a government research analyst at the Office of Inspector General who has analyzed Medicare Advantage overbilling.

The Justice Department has brought or joined 12 of the 21 cases that have been made public. But whistle-blower cases remain secret until the department has evaluated them. “We’re aware of other cases that are under seal,” said Mary Inman, a partner at the firm Constantine Cannon, which represents many of the whistle-blowers.

But few analysts expect major legislative or regulatory changes to the program.

“Medicare Advantage overpayments are a political third rail,” said Dr. Richard Gilfillan, a former hospital and insurance executive and a former top regulator at Medicare, in an email. “The big health care plans know it’s wrong, and they know how to fix it, but they’re making too much money to stop. Their C.E.O.s should come to the table with Medicare as they did for the Affordable Care Act, end the coding frenzy, and let providers focus on better care, not more dollars for plans.”