Fred Schulte - Kaiser Health News
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Kaiser Health News has released never-before-seen details of federal audits as the government weighs action against dozens of Medicare Advantage plans.
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Private equity firms have shelled out almost $1 trillion to acquire nearly 8,000 health care businesses across the country - including Florida - in deals almost always hidden from federal regulators.
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The lawsuit was filed by Kaiser Health News three years ago to learn about vast overcharges by the popular health plans that are detailed in audits the government refused to release to the public.
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The Government Accountability Office and the Health and Human Services inspector general’s office say seniors enrolled in the program are suffering and taxpayers are getting bilked for billions of dollars a year.
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"It's hard to know whether they're advocating for their business interests or for the seniors that they are supposed to represent,” says the director of the Committee for a Responsible Federal Budget, a nonpartisan group.
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Prosecutors say two executives with SpineFrontier are accused of paying millions of dollars in bribes disguised as consulting fees to surgeons in exchange for the surgeons using the manufacturer's products.
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As the Trump administration calls for expanding access to Medicare Advantage, a federal whistleblower lawsuit accuses a large Medicare Advantage plan of bilking Medicare out of $8 million.
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A lawsuit filed by Kaiser Health News under the Freedom of Information Act could spur the Centers for Medicare & Medicaid Services to release audits that document up to $650 million in overcharges.
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A federal audit and a whistleblower lawsuit allege that Medicare Advantage plans from the St. Louis-based Essence Group Holdings Corp. have significantly overcharged taxpayers.
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The federal government wants to deploy several new tools for catching insurers that have overcharged Medicare $30 billion in the past three years alone. But the insurance industry is balking.