Excerpts from this story referencing Medicare

"… 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 …"

Excerpts from this story referencing Medicare

"… 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 …"

Excerpts from this story referencing Medicare

"… 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. …"

Excerpts from this story referencing Medicare

"… 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 …"

Excerpts from this story referencing Medicare

"… 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 …"

Excerpts from this story referencing Medicare

"… 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 …"

Excerpts from this story referencing Medicare

"… 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 …"

Excerpts from this story referencing Medicare

"… . 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 …"

Excerpts from this story referencing Medicare

"… 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 …"

Excerpts from this story referencing Medicare

"… 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 …"

Excerpts from this story referencing Medicare

"… 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 …"

Excerpts from this story referencing 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 …"

Excerpts from this story referencing Medicare

"… 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 …"

Excerpts from this story referencing Medicare

"… 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 …"

Excerpts from this story referencing Medicare

"… 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 …"

Excerpts from this story referencing Medicare

"… 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 …"

Excerpts from this story referencing Medicare

"… 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 …"

Excerpts from this story referencing Medicare

"… 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 …"

Excerpts from this story referencing Medicare

"… 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” …"

Excerpts from this story referencing Medicare

"… 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 …"

Excerpts from this story referencing Medicare

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

"… xpayers billions of dollars every year, a top government researcher says. Medicare pays the privately-run Advantage health insurance plans, which cover more …"

"… n criticized for allegedly overstating how sick some patients are to boost Medicare revenue, a practice known as “upcoding.” Researcher Richard Kronick, …"

Excerpts from this story referencing Medicare

"… sota retiree Doug Morphew needed surgery last year, he expected his Humana Medicare Advantage plan to step up and pay the lion’s share of the bill. Morphew …"

"… t Morphew’s formal complaint, and about two dozen others, to Centers for Medicare and Medicaid Services (CMS) administrator Marilyn B. Tavenner. Swanson ask …"

"… .” CMS said it is satisfied that Humana has largely fixed any problems. Medicare pays the privately run health plans — an alternative to traditional Medi …"

Excerpts from this story referencing Medicare

"… on the proposal is due by November 1. …"

"… ns exaggerate how sick their patients are and how much they cost to treat. Medicare expects to pay the privately run plans — an alternative to traditional M …"

"… e expects to pay the privately run plans — an alternative to traditional Medicare — some $160 billion this year. The HHS study does not directly accuse a …"

Excerpts from this story referencing Medicare

"… lic. The case is pending. …"

"… ally, are seeking new power to recover excessive charges. The Centers for Medicare and Medicaid Services says its wants to set up “a formal process to reco …"

"… Center for Public Integrity investigation published last month found that Medicare paid the health plans nearly $70 billion in “improper” payments — mo …"

Excerpts from this story referencing Medicare

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

"… Commerce. The hearing was called to assess fraud and abuse safeguards in Medicare, which last year covered about 51 million people at a cost to taxpayers of …"

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

Excerpts from this story referencing Medicare

"… 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, …"

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

"… lans from 2008 to 2013, mostly overbillings, by manipulating or misusing a Medicare payment tool called a “risk score.” From 2007 through 2011, Medicare …"

Excerpts from this story referencing Medicare

"… y Gordon Witkin.      …"

"… ls that billions of tax dollars are wasted every year through leakage of a Medicare payment tool called a "risk score". Get involved   If you are a hea …"

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

Excerpts from this story referencing Medicare

"… 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. …"

"… re than people might think. Home visits have risen sharply at many private Medicare health plans, which treat close to 16 million elderly and disabled people …"

"… tory of heart trouble that’s flared up. Health plans can profit because Medicare pays them higher rates for sicker patients using a billing formula known a …"

Excerpts from this story referencing Medicare

"… ng their policies.” …"

"… have based on the benefits they were providing to seniors. So we cut what Medicare gives to these private insurance companies,” the Minnesota Democrat into …"

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

Excerpts from this story referencing Medicare

"… ouch it you get nailed.” …"

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

"… that these abuses could be wasting taxpayer dollars at a ferocious clip. Medicare expects to pay higher rates for legitimately sicker people who may require …"

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