$70 billion. That's a lot of billing errors! As a taxpayer, did you know you are footing this massive bill? I'd call that one big money grab.
Billing errors linked to a Medicare Advantage payment tool called a risk score, which pays higher rates for sicker patients, have resulted in more revenue for health plans at the taxpayers' expense. When risk scores overstate a patient's illness, health plans make more money from Medicare Advantage whether the patients are treated for that illness or not.
Center reporters spent more than a year analyzing enrollment data, as well as thousands of pages of government audits, research papers and other documents so we could reveal what's really happening behind the scenes and inform you of this betrayal of public trust.
Without watchdogs like the Center for Public Integrity, there's a slim chance that patients or the public would have found out about deceptions such as these. Federal officials have kept most audit results confidential, shielding the identities of specific health plans from public scrutiny. That's why I'm asking for your help.
- In Arizona, a health plan collected thousands of dollars from Medicare Advantage to treat congestive heart failure in a patient seen for a knee injury, according to auditors.
- In Pennsylvania, a person treated for blurry vision was documented as having serious heart disease.
Much of the story has yet to be told and we need your support to continue digging for the truth.
Which health plans have been overpaid — and by how much — remains a mystery. The Center has sued the federal government to reveal the details of these undisclosed audits. Will you contribute to our efforts?
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