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
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
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...