Excerpts from this story referencing Medicare Advantage

"… of overcharging the federal government by more than $1 billion through its Medicare Advantage plans. In a 79-page lawsuit filed late Tuesday in Los Angeles, the Justic …"

"… ing, a former finance director for the UnitedHealth division that oversees Medicare Advantage Plans. Under the False Claims Act, private parties can sue on behalf of th …"

"… f any money recovered. UnitedHealth is the nation’s biggest operator of Medicare Advantage plans, covering about 3.6 million patients in 2016, when Medicare paid the …"

Excerpts from this story referencing Medicare Advantage

"… it that accuses insurance giant UnitedHealth Group of fraud in its popular Medicare Advantage health plans. Justice officials filed legal papers to intervene in the su …"

"… another whistleblower. Swoben has accused the insurer of “gaming” the Medicare Advantage payment system by “making patients look sicker than they are,” said hi …"

"… ing by the company. “We are honored to serve millions of seniors through Medicare Advantage, proud of the access to quality health care we provided, and confident we …"

Excerpts from this story referencing Medicare Advantage

"… etes and depression. The Center for Public Integrity recently obtained 37 Medicare Advantage plan audits from federal health officials through a Freedom of Information …"

"… ince been paid back— many plans are still  appealing the findings. Medicare Advantage is a privately-run option to standard Medicare which has been growing in p …"

"… billings based on a formula called a risk score, which is designed to pay Medicare Advantage plans higher rates for sicker patients and less for people in good health. …"

Excerpts from this story referencing Medicare Advantage

"… n late February, is pending. Humana has declined to comment on it. …"

"… nd that upcoming audits will recover tens of millions more. “As the MA (Medicare Advantage) program continues to grow, safeguarding the program from loss is critical …"

"… udit in October 2014 in the wake of the Center for Public Integrity’s “Medicare Advantage Money Grab” series. The articles documented nearly $70 billion in “imp …"

Excerpts from this story referencing Medicare Advantage

"… eporter Fred Schulte’s investigative series into systematic waste in the Medicare Advantage program has been awarded second place in the Awards for Excellence in Heal …"

"… roject for the Center found that billions of dollars paid to privately run Medicare Advantage plans are wasted every year through manipulation  of “risk scores. …"

"… 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 cost to taxpa …"

Excerpts from this story referencing Medicare Advantage

"… 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 dubbing th …"

"… it would do just that —which meant about five percent of the roughly 600 Medicare Advantage contracts in force would be audited in a year. The agency expected to com …"

"… h a court order in a Freedom of Information Act lawsuit. The privately-run Medicare Advantage plans offer seniors an alternative to traditional Medicare and in recent y …"

Excerpts from this story referencing Medicare Advantage

"… years alleging billing fraud and lax government oversight of privately-run Medicare Advantage plans that have proven increasingly popular with senior citizens.  &n …"

"… visit elderly people in their homes and evaluate their health on behalf of Medicare Advantage plans. But the health assessments exaggerated how ill patients were, whic …"

"… health plans, according to the allegations in the suit. The suit names 30 Medicare Advantage plans in 15 states, including several Blue Cross plans and other industry …"

Excerpts from this story referencing Medicare Advantage

"… sed as the result of a lawsuit detail widespread billing errors in private Medicare Advantage health plans going back years, including overpayments of thousands of doll …"

"… thousands of dollars a year for some patients. Since 2004, privately run Medicare Advantage plans, an increasingly popular alternative to traditional Medicare, have b …"

"… striking new evidence of billing mistakes – mostly overcharges –in the Medicare Advantage program. Four of the audits were recently obtained by the Center for Publi …"

Excerpts from this story referencing Medicare Advantage

"… re McCaskill wants federal officials to step up oversight of privately-run Medicare Advantage health plans treating the elderly, citing allegations by whistleblowers th …"

"… es E. Grassley asked Attorney General Loretta Lynch to tighten scrutiny of Medicare Advantage health plans suspected of overcharging the government, saying billions of …"

"… billing tool called a “risk score,” which is intended to pay Medicare Advantage insurers higher rates for taking sicker people and less for those with few …"

Excerpts from this story referencing Medicare Advantage

"… ormula the government uses to pay private insurers that participate in the Medicare Advantage program “triggered widespread billing errors and overcharges” that was …"

"… ion request seeking records going back several years regarding payments to Medicare Advantage plans. The Medicare Advantage program is a privately run alternative to s …"

"… ng back several years regarding payments to Medicare Advantage plans. The Medicare Advantage program is a privately run alternative to standard Medicare. Close to a th …"

Excerpts from this story referencing Medicare Advantage

"… ons of tax dollars, newly released government records show. Privately run Medicare Advantage plans offer an alternative to standard Medicare, which pays doctors for ea …"

"… standard Medicare, which pays doctors for each service they render. Under Medicare Advantage, the federal government pays the private health plans a set monthly f …"

"… le for Medicare — and more are expected to follow. Supporters argue that Medicare Advantage improves care while costing members less out of pocket than standard Medic …"

Excerpts from this story referencing Medicare Advantage

"… U.S. Attorney’s Office,” Humana wrote.   The privately run Medicare Advantage plans offer seniors an alternative to standard Medicare, which pays doctor …"

"… icare, which pays doctors for each service they render. By contrast, under Medicare Advantage, the health plans are paid a set fee monthly for each patient based on a c …"

"… st year. The Center first disclosed multiple investigations of the Humana Medicare Advantage plan last May based on records filed by the U.S. Attorney’s Office in a …"

Excerpts from this story referencing Medicare Advantage

"… 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 with Humana …"

"… 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 the doc …"

Excerpts from this story referencing Medicare Advantage

"… 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 over the next …"

"… nters for Medicare and Medicaid Services, which oversees the privately-run Medicare Advantage plans that now provide health insurance to more than 16 million seniors.&n …"

"… the Better Medicare Alliance, a group formed late in 2014 to advocate for Medicare Advantage plans. “Medicare Advantage has been subject to billions in real cuts fo …"

Excerpts from this story referencing Medicare Advantage

"… yer Journalism Award for social science reporting.  The series, Medicare Advantage Money Grab, documented how Medicare Advantage plans, created more tha …"

"… nbsp; The series, Medicare Advantage Money Grab, documented how Medicare Advantage plans, created more than a decade ago to control health care spending on t …"

"… patients and less for healthy people — but it often pays too much. Medicare Advantage plans now cover nearly 16 million seniors at an estimated cost to taxpayer …"

Excerpts from this story referencing Medicare Advantage

"… 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 expanding un …"

"… aid waste, fraud and abuse, said it would conduct “various reviews” of Medicare Advantage billing practices with an eye toward curbing overcharges. Results are due …"

"… lent sign ups. The Inspector General’s office did not say if individual Medicare Advantage plans would be audited, but indicated it would focus on concerns that some …"

Excerpts from this story referencing Medicare Advantage

"… legations. …"

"… are paid accurately and that any overpayments are recovered for taxpayers. Medicare Advantage is an alternative to standard Medicare and is mostly run by private insura …"

"… The GAO audit comes in the wake of the Center for Public Integrity’s “Medicare Advantage Money Grab” series published in June, which showed that the government h …"

Excerpts from this story referencing Medicare Advantage

"… s need to do a better job ferreting out billing errors and overpayments to Medicare Advantage plans — mistakes which are estimated to cost taxpayers billions of dolla …"

"… that seem to diagnose much higher-than-expected rates of patient illness. Medicare Advantage plans that have been “significantly more aggressive than average in repo …"

"… group, spent nearly $5 million lobbying on a variety of issues, including Medicare Advantage, from January through June of 2014, according to the Senate records. But …"

Excerpts from this story referencing Medicare Advantage

"… lic. The case is pending. …"

"… s Health Insurance Plans, the industry’s trade group. Congress created Medicare Advantage and introduced risk scores in 2003 as a way to encourage private insurance …"

"… ore contentious question. The Center for Public Integrity’s analysis of Medicare Advantage plan data from 2007 through 2011 confirmed that risk scores rose more than …"

Excerpts from this story referencing Medicare Advantage

"… ederal officials need to step up efforts to investigate fraud and abuse in Medicare Advantage health plans treating millions of elderly Americans, a top government inve …"

"… $50 billion of that amount was paid improperly, including $11.8 billion to Medicare Advantage plans. A Center for Public Integrity investigation published earlier this …"

"… ed earlier this month found as much as $70 billion of improper payments to Medicare Advantage plans from 2008 through last year. The Center’s investigation attribute …"

Excerpts from this story referencing Medicare Advantage

"… te House, regardless of who is sitting in the Oval Office. The Center’s Medicare Advantage Money Grab investigation, led by veteran reporter Fred Schulte, found that …"

"… Federal officials made nearly $70 billion in “improper” payments to Medicare Advantage plans from 2008 to 2013, mostly overbillings, by manipulating or misusing …"

"… Medicare payment tool called a “risk score.” From 2007 through 2011, Medicare Advantage risk scores rose more than twice as fast as the average for people in stan …"

Excerpts from this story referencing Medicare Advantage

"… ng their policies.” …"

"… thanked by industry surrogates for their help in killing some of the same Medicare Advantage cuts he’d previously supported so forcefully. By most accounts it was a …"

"… rs of Congress and the Obama administration, and a forceful flexing of the Medicare Advantage industry’s growing political might in Washington. John Gorman, a top Me …"

Excerpts from this story referencing Medicare Advantage

"… y Gordon Witkin.      …"

"… are a health professional or medical coder and have a story to tell about Medicare Advantage billing issues or “risk scores”, please send Fred Schulte an emai …"

"… res”, please send Fred Schulte an email. If you are a patient in a Medicare Advantage plan and have been scheduled for a “home visit” let us know your opini …"

Excerpts from this story referencing Medicare Advantage

"… itizens who called Arizona insurance agent Denise Early wondered why their Medicare Advantage health plans were eager to send a doctor to visit them at home. A few wor …"

"… e cottage industry is flourishing as federal officials struggle to prevent Medicare Advantage plans from overcharging the government by billions of dollars every year, …"

"… has found. Medicare made nearly $70 billion in “improper” payments to Medicare Advantage plans from 2008 through 2013, mostly overbillings based on inflated risk s …"

Excerpts from this story referencing Medicare Advantage

"… indings signaled that billing errors could be deeply rooted within private Medicare Advantage plans — which contract with the federal government to care for nearly 16 …"

"… eturned. The Center for Public Integrity’s yearlong investigation of the Medicare Advantage industry found that federal officials over the past decade have missed mul …"

"… s C. Hill said insiders have known of “significant problems” with Medicare Advantage billing practices for years. But they’ve received scant public notice be …"

Excerpts from this story referencing Medicare Advantage

"… should be some accountability. …"

"… llion this year, but our latest investigation found that manipulation of a Medicare Advantage payment tool called a “risk score” is adding billions to the program's …"

"… journalist Fred Schulte. For more than a year, he’s been investigating Medicare Advantage, the government-backed alternative to Medicare for seniors run mostly by p …"

Excerpts from this story referencing Medicare Advantage

"… had those diseases. These health plans and hundreds of others are part of Medicare Advantage, a program created by Congress in 2003 to help stabilize health care spend …"

"… the Center for Public Integrity has found. Dominated by private insurers, Medicare Advantage now covers nearly 16 million Americans at a cost expected to top $150 bill …"

"… pected to top $150 billion this year. Many seniors choose the managed-care Medicare Advantage option instead of the traditional government-run Medicare program because …"

Excerpts from this story referencing Medicare Advantage

"… dicare will pay for. Doctors bill Medicare for each service they provide. Medicare Advantage: Nearly 16 million seniors have joined about 700 insurance plans that acce …"

"… lly considered the most costly to treat. In-Home Health Assessments: Medicare Advantage plans tout these free “house calls” as a major health benefit. But the …"

"… ed, which would reduce overpayments. Risk Score: Since 2004, CMS has paid Medicare Advantage plans based on a risk score that is supposed to assess the overall health …"

Excerpts from this story referencing Medicare Advantage

"… can answer it, we'll do so and add it here. …"

"… e will pay for. This option is called “fee-for-service.” By contrast, Medicare Advantage plans accept a set fee from the government for covering a person’s healt …"

"… nd eyeglasses and cost patients less out of pocket than standard Medicare. Medicare Advantage is growing rapidly and now serves about 16 million people, about a third o …"

Excerpts from this story referencing Medicare Advantage

"… n purposes only. …"

"… in the Health Insurance Portability and Accountability Act (HIPAA), small Medicare Advantage plans with 10 or less people are omitted from the data so that patient ide …"

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