Audits of Medicare Advantage plans find rampant overcharging for elderly patients
Many Medicare Advantage plans overcharged the federal government for treating older beneficiaries, according to a new report from the Center for Public Integrity.
The report included an analysis of 37 previously unreleased Medicare Advantage audits from 2007. Out of those 37 audits, 35 showed that the plan overcharged the government for treating elderly enrollees, often by overstating the severity of medical conditions.
The overpayments — which typically amounted to several hundred thousand dollars — have since been paid back, but the high rate of overcharging “could signal millions in losses to federal taxpayers,” according to the report.
The Center for Public Integrity also found that auditors were only able to confirm 60% of the medical conditions the insurance plans reportedly treated, with conditions like diabetes and depression scoring lower confirmation rates.
Overall, the audits found that the Medicare Advantage plans were three times more likely to charge the program too much, rather than too little, for the 70 medical conditions examined.
The CPI's report follows a May report from the Government Accountability Office that found CMS' efforts to recover Medicare Advantage overpayments need improvement.