Medicare
Phantom Medicare Billing
What is Phantom Billing? By Berger Montague Attorneys. Medicare fraud broadly refers to any individual, company or corporation who acts intentionally to steal money from the federal government. “Phantom billing” is a specific kind of Medicare… Read More
The Problem with Medicare Advantage
Medicare’s Private Option Is Gaining Popularity, and Critics. As more Americans sign up for Medicare Advantage, detractors worry that it’s helping private insurers more than patients. When Ed Stein signed up for Medicare eight years...
For Medicare Patients, Costs of MS Drugs Rise Sevenfold Over 10 Years
By Amy Norton, U.S. News. Medicare patients with multiple sclerosis (MS) saw their medication costs soar by more than sevenfold over a decade, a new study finds. It’s no secret that the costs of MS… Read More
Costly Confusion – Medicare’s Wellness Visit Isn’t The Same As An Annual Physical
Medicare does not cover an annual physical exam and patients who get them may be on the hook for the entire amount. By Michelle Andrews, Kaiser Health News. When Beverly Dunn called her new primary… Read More
Medicare Advantage Organizations Overturn 75% of Their Denials
By Kelly Gooch, Beckers Hospital Review. A recent investigation by the U.S. Office of Inspector General found between 2014 and 2016, Medicare Advantage organizations overturned 75 percent of their preauthorization and payment denials upon appeal. The OIG’s… Read More
DaVita Settles Huge Whistleblower Lawsuit Over Medicare Fraud
By Fred Schulte, KHN News. One of the nation’s largest dialysis providers will pay $270 million to settle a whistleblower’s allegation that it helped Medicare Advantage insurance plans cheat the government for several years. The settlement… Read More
Biggest Medicare Fraud Scheme in History
By Jay Weaver, The Miami Herald One of the state’s wealthiest healthcare operators was arrested Friday at his Miami Beach waterfront estate on charges of orchestrating the nation’s biggest Medicare fraud scheme — $1 billion…. Read More
Justice Department Joins Medicare Advantage $1B Fraud Lawsuit Against UnitedHealth
By Shelby Livingston, Modern Healthcare. The U.S. Justice Department has joined a whistle-blower lawsuit claiming that UnitedHealth Group and affiliated health plans have been gaming the Medicare program and fraudulently collecting millions of dollars by claiming… Read More
Seniors Dropping Medicare Advantage Plans
As Seniors Get Sicker, They’re More Likely To Drop Medicare Advantage Plans. A GAO report questions the quality of a number of Medicare Advantage plans after large numbers of sicker enrollees dropped them. When Sol...