Article Summary: Humana has overstated the severity of illness of some patients and has overcharged Medicare in a recent OIG audit finding. By Fred Schulte, NPR, Apr 20, 2021. A Humana Inc. health plan for… Read More
When a provider treats a Medicare patient, the provider must tell Medicare what services were provided so that Medicare can reimburse the doctor the correct amount. Certain services have higher reimbursement amounts than others –a… Read More
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
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...
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
Medicare does not cover an annual physical exam and patients who get them may be on the hook for the entire amount. When Beverly Dunn called her new primary care doctor’s office last November to...
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
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
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