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"… e for a story on a GAO report that essentially confirmed Fred’s terrific Medicare Advantage stories. The pickup also underscored the power of Fred’s work, …"
"… , and picked up by Kaiser Health News, POLITICO and STAT. Fred’s ongoing Medicare reporting also got a shout-out from the Washington Post. More long hours …"
"… n late February, is pending. Humana has declined to comment on it. …"
"… ly. The privately run plans, an alternative to traditional fee-for-service Medicare, have proven popular with seniors and have enrolled more than 17 mil …"
"… ity investigation, also enjoy strong support in Congress. GAO took aim at Medicare’s primary tactic for recouping overcharges, a secretive, and lengthy, au …"
"… e giant Humana Inc., which operates some of the nation’s largest private Medicare health plans, knew for years of billing fraud at some South Florida clinic …"
"… ky-based insurer, which treats more than 3 million elderly patients in its Medicare Advantage plans nationwide. The case could also spotlight costly flaws in …"
"… in the government’s complex and controversial method for paying private Medicare health plans. The Baez suit targets a billing formula called a risk score …"
"… eporter Fred Schulte’s investigative series into systematic waste in the Medicare Advantage program has been awarded second place in the Awards for Excellen …"
"… roject for the Center found that billions of dollars paid to privately run Medicare Advantage plans are wasted every year through manipulation of “ris …"
"… ients and less for healthy people – but the formula often pays too much. Medicare Advantage plans now cover more than 16 million seniors at an estimated cos …"
"… shes the stabbing pain rheumatoid arthritis causes in her joints. Although Medicare helps cut the $40,000-per-year list price for prescription Enbrel, she sai …"
"… ished with NPR. …"
"… he money as possible, newly released government records show. Centers for Medicare and Medicaid Services records reveal that officials there as early as 2008 …"
"… that officials there as early as 2008 identified a group of privately-run Medicare Advantage health plans they suspected of ripping off the government, even …"
"… every tool at our disposal…” Donovan cited problems with traditional Medicare, which pays doctors and hospitals on a “fee-for-service” basis, as wel …"
"… ch pays doctors and hospitals on a “fee-for-service” basis, as well as Medicare Advantage, its fast-growing, privately run alternative. The private insura …"
"… not respond to emails and a phone message seeking comment. The Centers for Medicare and Medicaid Services, the branch of HHS which oversees the health program …"
"… e to do that.” …"
"… rally funded but privately run alternatives to traditional fee-for-service Medicare, can provide better care—at lower cost—than the government. One of my …"
"… elieved the PR, so much so that I encouraged my own parents to enroll in a Medicare Advantage plan. But is the PR true? The answer is, we don’t know, and we …"
"… g firm and more than two dozen health plans for the elderly of ripping off Medicare by conducting in-home patient exams that allegedly overstated how much the …"
"… years alleging billing fraud and lax government oversight of privately-run Medicare Advantage plans that have proven increasingly popular with senior citizens …"
"… visit elderly people in their homes and evaluate their health on behalf of Medicare Advantage plans. But the health assessments exaggerated how ill patients …"
"… icans have long dreamed of finding a way to either privatize or get rid of Medicare, a program that has provided access to health care for well over 100 milli …"
"… clear a few days ago, that dream is still alive. While many Democrats and Medicare beneficiaries were making plans to celebrate the program’s 50th birthday …"
"… nders of Vermont hailed it as a huge success during a speech at a rally of Medicare-for-All supporters outside the Capitol Thursday—Bush was telling a small …"
"… Marilyn Tavenner, who served as the chief administrator of the Centers for Medicare and Medicare Services from 2013 until she stepped down in February. Taven …"
"… ner, who served as the chief administrator of the Centers for Medicare and Medicare Services from 2013 until she stepped down in February. Tavenner’s appoi …"
"… wartz, a Pennsylvania Democrat, to head its newest front group, the Better Medicare Alliance. These two hires tell us all we need to know about where insuran …"
"… at work. And in an ironic twist, the GOP’s insistence that billions of Medicare dollars must flow through private insurers is a major factor in the recent …"
"… e of the aging Baby Boomers. Millions of Boomers are becoming eligible for Medicare every year, and the Medicare program has contributed billions of dollars i …"
"… Millions of Boomers are becoming eligible for Medicare every year, and the Medicare program has contributed billions of dollars in revenue and profits to the …"
"… sed as the result of a lawsuit detail widespread billing errors in private Medicare Advantage health plans going back years, including overpayments of thousan …"
"… thousands of dollars a year for some patients. Since 2004, privately run Medicare Advantage plans, an increasingly popular alternative to traditional Medica …"
"… dicare Advantage plans, an increasingly popular alternative to traditional Medicare, have been paid using a risk score calculated for each patient who joins. …"
"… d in a secret legal battle with UnitedHealth Group, the nation’s biggest Medicare Advantage insurer, after a government audit detected widespread overbillin …"
"… ns, newly released records show. The audit, completed in 2012, found that Medicare had paid too much for nearly half of a sample of patients enrolled at Paci …"
"… RADV. They test the accuracy of a billing tool called a “risk score.” Medicare uses risk scores to pay health plans higher rates for sicker people and le …"
"… ic Health. Using 2012 data provided by 4,483 hospitals to the Centers for Medicare and Medicaid Services, Bai and Anderson found that those 50 had an average …"
"… erson found that those 50 had an average markup of 1,013 percent over what Medicare pays for the thousands of items on hospitals’ “chargemasters.” (Char …"
"… t the hospital charged $79,350 to treat a hemorrhage. That’s compared to Medicare’s reimbursement of $5,177. As the authors noted in their Health Affairs …"
"… for the government to negotiate with drug companies when they enacted the Medicare drug benefit in 2003. It’s telling that, in response to Ignagni’s rhe …"
"… re McCaskill wants federal officials to step up oversight of privately-run Medicare Advantage health plans treating the elderly, citing allegations by whistle …"
"… es E. Grassley asked Attorney General Loretta Lynch to tighten scrutiny of Medicare Advantage health plans suspected of overcharging the government, saying bi …"
"… billing tool called a “risk score,” which is intended to pay Medicare Advantage insurers higher rates for taking sicker people and less for thos …"
"… . Grassley has asked Attorney General Loretta Lynch to tighten scrutiny of Medicare Advantage health plans suspected of overcharging the government, saying bi …"
"… rs to Lynch and Andrew M. Slavitt, acting Administrator of the Centers for Medicare and Medicaid Services, Grassley wanted to know what both agencies have don …"
"… surance program for years. “Safeguards become all the more important as Medicare Advantage adds more patients and billions of dollars of hard-earned taxpay …"
"… as mostly a ho-hum day on Wall Street — but not for companies offering Medicare Advantage plans. Several of those firms hit the jackpot, tacking on billio …"
"… harging the government. The stocks took off after the federal Centers for Medicare and Medicaid Services advised the health plans in a memo that it was rethi …"
"… mo that it was rethinking a move to ratchet up audits of the privately run Medicare plans. Some of these plans are run by publicly traded insurance companies …"
"… side the Beltway. “Today I will begin as President and CEO of the Better Medicare Alliance,” she told her “friends and supporters.” The Better Medica …"
"… dicare Alliance,” she told her “friends and supporters.” The Better Medicare Alliance is a so-called 501(c)(3) nonprofit that appears to have been crea …"
"… with APCO on several projects during my years at Cigna. The Better Medicare Alliance’s raison d’etre is to widen the federal spigot of taxpayer do …"
"… week to inform us that it recovered $3.3 billion in fraudulent payments to Medicare health care providers in fiscal year 2014. Officials even went so far as t …"
"… urnal, which, like the Center for Public Integrity, has been investigating Medicare fraud and abuse. In a story that appeared in the Journal before the offic …"
"… ve cracked down on tens of thousands of health care providers suspected of Medicare fraud,” an effort she said is helping to extend the life of the Medicare …"
"… l health officials were advised in 2009 that a formula used to pay private Medicare plans triggered widespread billing errors and overcharges that have since …"
"… ons of tax dollars, newly released government records show. Privately run Medicare Advantage plans offer an alternative to standard Medicare, which pays doct …"
"… . Privately run Medicare Advantage plans offer an alternative to standard Medicare, which pays doctors for each service they render. Under Medicare Advantage …"
"… d the government by claiming some elderly patients enrolled in its popular Medicare plans are sicker than they actually are. The Louisville, Kentucky-based c …"
"… U.S. Attorney’s Office,” Humana wrote. The privately run Medicare Advantage plans offer seniors an alternative to standard Medicare, which p …"
"… tely run Medicare Advantage plans offer seniors an alternative to standard Medicare, which pays doctors for each service they render. By contrast, under Medic …"
"… because we believe more cuts will harm beneficiaries,” she said. …"
"… ervices. The criminal case, believed to be among the first to take aim at Medicare Advantage billing tactics, centers on a South Florida doctor affiliated wi …"
"… ed with Humana Inc., one of the biggest players offering the privately run Medicare Advantage plans. A federal grand jury in West Palm Beach, Fl. indicted&nb …"
"… t Obama’s proposed 2016 budget takes a major swipe at waste and abuse in Medicare Advantage plans for the elderly, seeking more than $36 billion in cuts ove …"
"… iant Department of Health and Human Services. HHS includes the Centers for Medicare and Medicaid Services, which oversees the privately-run Medicare Advantage …"
"… nters for Medicare and Medicaid Services, which oversees the privately-run Medicare Advantage plans that now provide health insurance to more than 16 million …"
"… Public Integrity investigation detailing questionable spending by private Medicare plans has been awarded the prestigious Philip Meyer Journalism Award for s …"
"… yer Journalism Award for social science reporting. The series, Medicare Advantage Money Grab, documented how Medicare Advantage plans, create …"
"… nbsp; The series, Medicare Advantage Money Grab, documented how Medicare Advantage plans, created more than a decade ago to control health care spe …"
"… site Nursing Home Compare than the average daily levels calculated through Medicare cost reports that are largely out of public view. In 2005 the Centers for …"
"… cost reports that are largely out of public view. In 2005 the Centers for Medicare and Medicaid Services, the agency responsible for nursing home oversight, …"
"… id the Medicaid cost reports that have much of the same information as the Medicare documents are generally more accurate than the self-reported data found on …"
"… ending on managed health care in the new fiscal year, ranging from private Medicare Advantage groups that treat millions of elderly to health plans rapidly ex …"
"… Health and Human Services Office of Inspector General, which investigates Medicare and Medicaid waste, fraud and abuse, said it would conduct “various revi …"
"… aid waste, fraud and abuse, said it would conduct “various reviews” of Medicare Advantage billing practices with an eye toward curbing overcharges. Result …"
"… m of diagnosing “false and fraudulent” medical conditions that several Medicare Advantage plans allegedly used to overcharge the federal government by $1 …"
"… nta Ana, California-based firm sends medical professionals to the homes of Medicare Advantage members to assess their health. Silingo claims she was fired la …"
"… fornia, was unsealed by a judge late last month. The suit also names four Medicare Advantage insurance plans which, Silingo alleges, “turned a blind eye” …"
"… legations. …"
"… are due next spring. GAO auditors will target efforts by the Centers for Medicare and Medicaid Services (CMS), which runs the senior care program, to ensure …"
"… are paid accurately and that any overpayments are recovered for taxpayers. Medicare Advantage is an alternative to standard Medicare and is mostly run by priv …"
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Donate to The Center for Public Integrity.