Privatizing Medicare is where the fraud, waste, and abuse comes in.
KFF Health News – In Settling Fraud Case, New York Medicare Advantage Insurer, CEO Will Pay up to $100M By Fred Schulte December 20, 2024 It also was one of the first to accuse a data mining firm of helping a health plan overcharge. The settlement is the latest in a whirl of whistleblower actions alleging billing fraud by a Medicare Advantage insurer. Medicare Advantage plans are private health plans that cover more than 33 million members, making up over half of all people eligible for Medicare. They are expected to grow further under the incoming Trump administration. But as Medicare Advantage has gained popularity, regulators at the federal Centers for Medicare & Medicaid Services have struggled to prevent health plans from exaggerating how sick patients are to boost their revenues. Whistleblowers such as Ross, a former medical coding professional, have helped the government claw back hundreds of millions of dollars in overpayments tied to alleged coding abuses. Ross will receive at least $8.2 million, according to the Justice Department.
Letter to reps:
More investigations need to be done in light of the Medicare Advantage insurer that used a data mining company to help with overcharging. I want to see Medicare Advantage completely retired as a failed and wasteful system in favour of traditional Medicare.