HEALTH CARE un-covered

HEALTH CARE un-covered

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DOJ Questions UnitedHealth Doctors Re: Medicare Advantage Upcoding
Inside the growing scrutiny of Medicare Advantage and the billing practices that put seniors and taxpayers on the hook.
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Wendell Potter
8
The Fundamental Problem at the Heart of American Health Insurance
Administrative waste, denials, and deadly incentives — the U.S. model shows what happens when profit rules.
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TR Reid
28
CMS is Trying to Expand Prior Authorization in Traditional Medicare Even Though All Data Points Say That’s a Bad Idea
Critics say CMS' new prior authorization model risks delays and denials for seniors.
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Rachel Madley
17
DOJ’s Largest Health Care Fraud Takedown Ever Should Make Us Ask: Why Is Our System So Easy to Exploit?
America’s fragmented system rewards both organized crime and corporate abuse.
 • 
Wendell Potter
 and 
Joey Rettino
31
Pharmacies In Desperate Need of an Antidote
Chains and independents alike are shuttering as pharmacy benefit managers tighten reimbursements.
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Luke Sullivan
8
The $8.6 Trillion Public-Private Partnership That Fails Us All
New government projections show U.S. health spending will eat more of our GDP while life expectancy and coverage rates decline — but AHIP and Wall…
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Wendell Potter
39

June 2025

Empty Plates: The Quiet Crisis Facing America’s Elderly
Budget battles in Congress leave 2.2 million seniors in limbo as local Meals on Wheels programs ration aid and stretch donations to feed the frail.
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Trudy Lieberman
15
Congress Could Force Patients in Rural America To Make Dire Medical Care Choices
Federal plan to cap Medicaid provider taxes puts rural hospitals on life support – threatening care for millions as states like Ohio and Kentucky brace…
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Luke Sullivan
11
Bipartisan GUARD Act Would (Finally) Make Insurers Pay — Not Just Veterans and Taxpayers
A rare bipartisan bill in Congress aims to end the health insurance industry’s billion-dollar scam that charges taxpayers twice for care only the VA…
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Wendell Potter
 and 
Joey Rettino
9
Health Insurance Industry Promises Reforms After $476 Million PR and Lobbying Campaign
Health insurers and their lobbying arms have spent $476.5 million since 2020 to block reform, protect profits, and mislead the public — and it’s coming…
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Wendell Potter
7
The Fox Guards the Hen House – Translating AHIP’s Commitments to Streamlining Prior Authorization
Health insurers delayed mandatory reforms, then rebranded them as voluntary pledges
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Seth Glickman
7
NYC Retirees Are Victorious Against Mayor Eric Adams Medicare Advantage Push
Mayor Eric Adams abruptly ends plan to force 250,000 retired city workers into a privatized health plan, marking a watershed win for a bipartisan…
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Wendell Potter
11
© 2025 Wendell Potter
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