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M o n d ay, au g u s t 4, 2025
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Medicare Advantage under scrutiny Critics say plan exaggerates health conditions, overcharges
BY MARK BALLARD Staff writer
STAFF PHOTOS By BRAD KEMP
ABOVE: Students have their hair cut on Sunday during the Kiwanis Club of Carencro Back to School Bash at the Carencro Community Center. Residents could donate items such as mesh or clear backpacks and gently used uniforms to the Comfort Closet to benefit local schools. BELOW LEFT: Hairstylist Nene Broussard, left, cuts the hair of student Kingston Malbrough, 7. BELOW RIGHT: Student Likely Harris, 10, has her hair styled by Molly Miller.
WASHINGTON — Medicare Advantage, the privately run insurance on which roughly 500,000 older Louisiana residents rely for health care, is facing calls for change in Congress. Though hugely popular, critics say Medicare Advantage programs exaggerate patients’ health conditions to receive more money from the federal government. They argue that it is draining the Medicare Trust Fund, which will run out of money in 2033, according to the fund’s report released two weeks ago. “Medicare is going insolvent, and our budget deficit is expanding. We need to stop overpaying where we can if we’re to preserve Medicare for Americans who rely on it,” said U.S. Sen Bill Cassidy, R-Baton Rouge. Cassidy has proposed changes he says would limit the practice called “upcoding.” The Congressional Budget Office estimated that changes to upcoding would save about $124 billion over 10 years. AARP, the nationwide interest group that advocates for seniors, backs Cassidy’s push. “Upcoding leads to both inflated payments and higher premiums,” said Denise Bottcher, state director of AARP Louisiana in Baton Rouge. “You’re just driving up the costs of health care.” But America’s Health Insurance Plans, the Washington-based trade association that represents the health insurance industry, opposes the bill. “We oppose cuts to Medicare Advantage, including the No UPCODE Act, and urge Congress to keep the promise to America’s seniors,” AHIP President Mike Tuffin said in a statement. Louisiana has more than 932,000 residents who are part of Medicare, 59% of whom are
ä See MEDICARE, page 4A
Settlement reached in lawsuit against UL system Woman alleged that universities mishandled reporting accused rapist
BY MATT BRUCE Staff writer
A woman was set to have her day in court this week in an effort to prove that institutional failures at two state universities allowed an accused serial sexual predator to swap schools, despite multiple reports of sexual misconduct, and transfer in the fall of 2018 to Louisiana Tech, where she said he
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raped her weeks after stepping foot on campus. But the woman reached a settlement with the University of Louisiana System late Friday, according to U.S. Middle District Court of Louisiana filings. Terms of the settlement were undisclosed as of Sunday. But the plaintiff’s attorney, Monica Beck, gave notice to the court Friday that the two sides have agreed in principal to a set-
tlement and are working toward finalizing the agreement ahead of a stipulated dismissal of the civil case. According to claims of Title IX violations alleged in the lawsuit, Victor Daniel Silva sexually assaulted the Indiana woman when she was an undergrad at Louisiana Tech. The incident allegedly occurred during a house party at Silva’s off-campus apartment. By
then, Silva was enrolled in his third school in less than four years and, according to the plaintiff’s lawsuit, he was allowed to cycle through public universities in Louisiana despite multiple reports that he sexually assaulted female students on or near the college campuses he attended. Louisiana Tech in Ruston is part of the UL system. So is the University of Louisiana at Lafayette. Silva spent time at both schools after first attending LSU, which is
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a public university but not part of the UL system. Silva has been accused of sexually assaulting six women at the three universities between 2014 and 2020. He’s never been formally charged or convicted in any of the assaults. The full array of accusations against Silva first came to light in a USA Today investigative report that illustrated how he repeatedly
ä See LAWSUIT, page 4A
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