GAO takes on Medicare Advantage spending

By Fred Schulte

GAO will investigate program spending.

Excerpts from this story referencing "Congress":

"… subsidiary of New-Jersey based Aveta, Inc., denied the allegations. …"

"… ars every year. The Government Accountability Office, the watchdog arm of Congress, is conducting the probe at the request of the House Ways and Means Commit …"

"… care Advantage has grown explosively under the risk-scoring formula, which Congress put in place in 2004. Officials expect the program to cost taxpayers as mu …"

"… essive. The Medicare Advantage industry has enjoyed bipartisan support in Congress as the program has grown. In recent years, the industry has successfully l …"

A call for more scrutiny of private Medicare Advantage plans

By Fred Schulte

Researchers say aggressive billing by private plans may require more scrutiny

Excerpts from this story referencing "Medicine":

"… . Graber, a physician and president of the Society to Improve Diagnosis in Medicine.  “Patients don’t have any idea how they are being coded.” Gra …"

Docs, drug companies, insurers drive up Medicare costs

By Wendell Potter

Commentary: reform drove down hospital costs, creating Medicare savings, but insurers, doctors and drug companies escaped cuts.

Excerpts from this story referencing "United States":

"… not only has created the severe shortage of primary care physicians in the United States, but it has also contributed to soaring health care costs, especially for …"

Medicare Advantage patients find themselves in regulatory limbo

By Fred Schulte

States lack oversight but feds are struggling to keep with fast-growing health plans.

Ten major findings from our investigations so far this year

By Jared Bennett and Sarah Whitmire

Investigations from the first half of 2014

Excerpts from this story referencing "Charles Lewis":

"… y year before. This year also marks the 25th Anniversary since our founder Charles Lewis started the Center from his guest bedroom.  But we still have a lot …"

How Medicare Advantage plans code for cash

By Fred Schulte

Federal study criticizes Medicare Advantage and calls for changes.

Feds seek new authority to recoup Medicare Advantage overcharges

By Fred Schulte

Impact: Feds act to recoup overcharges following Center investigation.

Excerpts from this story referencing "Texas":

"… om line costs,” said Geruso, an assistant professor at the University of Texas at Austin.  Sen. Charles Grassley, R-Iowa, said that refining the pa …"

Medicare Advantage plans require more scrutiny

By Fred Schulte

Government inspector says private Medicare plans difficult to investigate due to lack of access to data.

Praise for UK-style health system vindicates spurned nominee

By Wendell Potter

Former Medicare chief's support for UK's health care system may win votes in race for governor of Massachusetts.

Excerpts from this story referencing "Senate":

"… The Constitution allows presidents to make short-term appointments without Senate approval when Congress is not in session, and that is what Obama did. He a …"

"… xpire. Obama decided not to try again to get him confirmed after 42 of the Senate’s 47 Republicans, many of whom had claimed during the health care reform …"

Health insurance lobby keeps Medicare Advantage overpayments flowing

By Wendell Potter

Commentary: program bills are excessive, but don't expect reforms.

Excerpts from this story referencing "reporter":

"… The Center’s Medicare Advantage Money Grab investigation, led by veteran reporter Fred Schulte, found that: Federal officials made nearly $70 billion in …"

Get involved: Help Medicare Advantage investigation go further with donations and news tips

Join us in finding problems with Medicare Advantage billing, “risk scores”, or home visits.

Home is where the money is for Medicare Advantage plans

By Fred Schulte

Medicare Advantage home visits may not improve health, but boost risk scores and cost taxpayers billions.

Excerpts from this story referencing "Massachusetts":

"… their services as “revenue optimization.” Predilytics, a Burlington, Massachusetts, health information analytics firm, markets software to Medicare Advantage …"

Medicare Advantage lobbying machine steamrolls Congress

By Fred Schulte

Under pressure, Medicare Advantage critics morph into defenders.

Excerpts from this story referencing "Mitt Romney":

"… te floor in praise of the Affordable Care Act. Franken rebuked Republican Mitt Romney for his 2012 presidential campaign promise to “restore those billions an …"

Health insurers have their way with regulators

By Fred Schulte

Billions in Medicare Advantage overpayments likely gone for good.

Excerpts from this story referencing "Taxpayers Against Fraud":

"… se nobody ever dinged them.”  Patrick Burns, a co-director of Taxpayers Against Fraud, a Washington-based group, said that only stiff penalties will protect tax …"

New audits may recover missing millions — or not

By Fred Schulte

Secretive audits target some Medicare Advantage plans.

Excerpts from this story referencing "Obama administration":

"… ck on overpayments to Medicare Advantage plans has been a priority for the Obama administration. With the support of some key Democrats in Congress, the administration ha …"

"… hoped to use some of the savings for the Affordable Care Act. Still, the Obama administration has taken years to get the new round of RADV audits underway amid criticis …"

150 billion reasons Medicare Advantage matters

By Eleanor Bell

Reporter Fred Schulte discusses his investigation into billions of dollars misspent on Medicare Advantage plans.

Why Medicare Advantage costs taxpayers billions more than it should

By Fred Schulte, David Donald and Erin Durkin

Critics warned of billing abuse in Medicare Advantage health plans, but oversight is lagging.

Excerpts from this story referencing "Obama administration":

"… y to cover millions of uninsured people. That’s consistent with an early Obama administration promise to reduce payments to the health insurers. But support for Medica …"

Whistleblower suit says health plan cheated government out of more than $1 billion

By Fred Schulte

Lawsuit: executives worried health plan would be ‘screwed’ if feds heard of overcharges.

Excerpts from this story referencing "presidential race":

"… also was a health policy adviser to Republican Mitt Romney during the 2012 presidential race. Valdez said in court papers that he served as president of MSO of Puerto …"

Explaining Medicare Advantage, and why it matters to you

By Fred Schulte and Sarah Whitmire

Explaining risk scores, Medicare Advantage and what alleged overbilling could mean for the Affordable Care Act.

Methodology for 'Medicare Advantage Money Grab'

By David Donald and Erin Durkin

A behind-the-scenes look at the data analysis for the 'Medicare Advantage Money Grab' investigation.

Excerpts from this story referencing "Puerto Rico":

"… the annual payments at the national level, the Center excluded payments in Puerto Rico, as do most researchers working with MA data, due to significantly differe …"

Medicare Advantage made simple: a glossary

By Fred Schulte

Definitions for lesser-known terms relating to Medicare.

Excerpts from this story referencing "chronic diseases":

"… al Needs Plans: These are Medicare Advantage plans that enroll people with chronic diseases such as diabetes and take other steps to manage their care. …"

Center sues in an effort to make Medicare Advantage files public

By Fred Schulte

Center sues to make records public.

The Canadian health care system I disparaged

By Wendell Potter

Commentary: health care system up north is more efficient.

GOP opposition to Obamacare baffles Dr. Sullivan

By Wendell Potter

Commentary: former HHS Secretary Sullivan says Obamacare resembles plan crafted by Republicans.

Dental chain may be booted from Medicaid program

By David Heath

Small Smiles, under federal scrutiny for performing unnecessary dental treatments on children, could be barred from the Medicaid program.

Excerpts from this story referencing "Kool Smiles":

"… ic Integrity and PBS Frontline exposed similar practices at another chain, Kool Smiles, in a 2012 report titled “Dollars and Dentists.” Small Smiles’s own …"

Pay no attention to those insurance lobbyists behind the Medicare curtain!

By Wendell Potter

Commentary: 'grass-roots' campaign actually comes from health insurers.

Excerpts from this story referencing "Goldman Sachs":

"… to convert those excess payments into hefty profits. Financial analysts at Goldman Sachs estimated a few years ago that 66 percent of the net income at Humana, whe …"

Obamacare and emergency rooms: a bit of perspective needed

By Wendell Potter

Commentary: Oregon study cited by critics requires perspective.

Excerpts from this story referencing "Oregon":

"… bsp; …"

"… t — which began in some states on January 1 — many who wrote about the Oregon study jumped to the conclusion that the millions of newly enrolled Medicai …"

"… I may be going out on a limb, but I for one don’t buy the idea that the Oregon study means emergency rooms are going to get even more crowded. And t …"

"… ropriately and inexpensively in a clinic or doctor’s office.   The Oregon study, which was published in the journal Science, would seem to disprove …"

As glitches fade, Obamacare approval will rise

By Wendell Potter

Commentary: as website improves, customers are finding insurance deals.

Feds propose shakeup for emergency room billing

By Fred Schulte

Proposal seeks to counter alleged over-billing with standardized rate

Obamacare facts separated from spin by Wendell Potter, FactCheck.org

By Bill Buzenberg

Navigating the politicized issue of the Affordable Care Act is made easier by Wendell Potter and FactCheck.org.

Pages