Audits Reveal Millions in Medicare Advantage Overcharges – By Michael Rainey (The Fiscal Times) / Nov 21, 2022
Newly revealed federal audits show that some Medicare Advantage health plans have overcharged the government by millions of dollars.
The audits dating back to 2011 through 2013 were made available thanks to a multi-year Freedom of Information Act lawsuit by Kaiser Health News that was settled in September. Federal auditors reviewed the files of 18,090 patients and found overcharges of about $12 million, with some plans charging more than $1,000 too much per patient on average. Applying that rate to a broader range of Medicare Advantage plans suggests overcharges totaling roughly $650 million.
Officials at the Centers for Medicare & Medicaid Services say they plan to use the analysis to recover funds in the Medicare Advantage system, which is operated by large, private insurance companies. But the agency has failed to do so for nearly 10 years, and recently postponed the announcement of a final adjustment process for overcharges.
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