Fred Schulte - Kaiser Health News
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In a surprise decision, U.S. officials yield to insurance industry demands — at least for now. -
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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Federal audits of 37 Medicare Advantage health plans cited 35 for overbilling the government. Many plans, for example, claimed patients with depression or diabetes were sicker than they actually were.
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Privately run Medicare Advantage plans have overcharged the federal government by billions of dollars, yet Medicare hasn't been effective in recouping the excessive payments, an audit found.
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A whistleblower suit against Humana Inc. alleges the insurer turned a blind eye to billing fraud involving Medicare patients. People were diagnosed with more serious ailments than they actually had.
