Michael Dowell Discusses the Uncertain Impact of Growing Medicare Advantage Scrutiny

Hinshaw partner Michael Dowell was quoted in a recent Law360 Healthcare Authority article examining the federal government's increased scrutiny of Medicare Advantage and whether recent enforcement actions and regulatory changes might improve administration of the program.

In recent months, major Medicare Advantage organizations have faced lawsuits, settlements, government investigations, and sanctions as lawmakers and regulators try to address significant issues with the popular program, including projected overpayments of $76 billion this year.

High Medicare Advantage Costs Prompt Cuts to the Program

Michael noted that scrutiny of Medicare Advantage is not new, but historically, there has been reluctance to make cuts to the program. He sees that changing now, as the program's high costs are prompting more stakeholders to question whether it should continue as it is.

He added that the cost of Medicare Advantage is causing a small but growing number of people to say, “Hey, maybe the whole program should be trashed and go back to fee-for-service to save the government money.”

Pressure of Cutting the Federal Deficit

Michael also highlighted how the pressure on policymakers to cut the federal deficit is bringing about increased focus on Medicare Advantage overpayments, noting that “because of the significantly increased costs and their need to reduce the deficit, they're looking everywhere to cut costs.”

Additional Resources: Compliance Guidance for Medicare Advantage Organizations

For additional information, read Michael’s related Hinshaw Healthcare Alert, in which he explains key details and risks outlined in the Office of Inspector General’s (OIG) updated Medicare Advantage Compliance Program Guidance for Medicare Advantage Organizations (MAOs), delegated providers, and first-tier, downstream, and related entities (FDRs).

Read his actionable compliance roadmap, which covers immediate steps, contractual and structural reviews, and programmatic enhancements.

• • Law360 Healthcare Authority: “The Uncertain Impact of Medicare Advantage Scrutiny” (April 7, 2026)