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large Medicare Advantage organizationsKFF Health News
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86% Informative
A new audit finds billions of dollars in overcharges linked to Medicare Advantage home visits.
Health plans pocketed $7.5 billion in 2023 from diagnosing health conditions that prompted no medical services.
The Centers for Medicare & Medicaid Services has rejected a recommendation to limit payments stemming from house visits that don’t result in any medical treatment.
The in-home visits have sparked controversy for more than a decade .
Court filings show CMS officials were concerned years ago that home visits and chart reviews could needlessly drive up costs.
In April 2014 , CMS backed off a proposal to restrict their use amid complaints from the industry that it would lose billions of dollars as a result.
CMS officials also had concerns that unchecked home visits might affect efforts to recover overpayments through billing reviews.
VR Score
89
Informative language
90
Neutral language
48
Article tone
semi-formal
Language
English
Language complexity
55
Offensive language
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Hate speech
not hateful
Attention-grabbing headline
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Known propaganda techniques
not detected
Time-value
short-lived
External references
8
Source diversity
6
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