After Industry Uproar, Feds Killed Plan to Curb Medicare Advantage Overbilling

  • 📰 truthout
  • ⏱ Reading Time:
  • 66 sec. here
  • 3 min. at publisher
  • 📊 Quality Score:
  • News: 30%
  • Publisher: 68%

United Kingdom News News

United Kingdom United Kingdom Latest News,United Kingdom United Kingdom Headlines

The issue is at the center of a DOJ civil fraud case against UnitedHealth Group pending in federal court.

Advocates hold signs during a news conference on Medicare Advantage plans in front of the U.S. Capitol on July 25, 2023, in Washington, D.C.A decade ago, federal officials drafted a plan to discourage Medicare Advantage health insurers from overcharging the government by billions of dollars — only to abruptly back off amid an “uproar” from the industry, newly released court filings show.

The Justice Department alleges the giant health insurer cheated Medicare out of more than $2 billion by reviewing patients’ records to find additional diagnoses, adding revenue while ignoring overcharges that might reduce bills. The company “buried its head in the sand and did nothing but keep the money,” DOJ said in a court filing.

Spokespeople for the Justice Department and CMS declined to comment for this article. In an email, UnitedHealth Group spokesperson Heather Soule said the company’s “business practices have always been transparent, lawful and compliant with CMS regulations.”, more than half of people eligible for Medicare.

Exactly who made the call to withdraw the chart review proposal isn’t clear from court filings so far. But Erin Fuse Brown, a professor at the Brown University School of Public Health, said the decision reflects a pattern of timid CMS oversight of the popular health plans for seniors. The complex case has featured years of legal jockeying, even pitting the recollections of key CMS staff members — including several who have since departed government for jobs in the industry — against those of UnitedHealthcare executives.Court filings describe a 45-minute video conference arranged by then-CMS administrator Marilyn Tavenner on April 29, 2014.

We have summarized this news so that you can read it quickly. If you are interested in the news, you can read the full text here. Read more:

 /  🏆 69. in UK
 

Thank you for your comment. Your comment will be published after being reviewed.
Please try again later.

United Kingdom United Kingdom Latest News, United Kingdom United Kingdom Headlines

Similar News:You can also read news stories similar to this one that we have collected from other news sources.

Feds killed plan to curb medicare advantage overbilling after industry oppositionRule would have required Medicare Advantage health insurers to identify overpayments and refund them to government.
Source: CBSNews - 🏆 87. / 68 Read more »

Japan’s Ministry of Economy, Trade & Industry Publishes Report on the Current State of Music IndustryJapan’s Ministry of Economy, Trade and Industry (METI) has published a report on its music industry.
Source: billboard - 🏆 112. / 63 Read more »