Democrats push GOP toward Medicare ‘upcoding’ instead of Medicaid cuts

Democratic lawmakers are asking GOP leadership to reject Medicaid cuts in favor of going after Medicare Advantage “upcoding” as a way of saving federal dollars and addressing waste, fraud and abuse. A ...
The Hill

AARP endorses bill to prevent upcoding in Medicare Advantage

The senior interest group is putting its backing behind bipartisan legislation aimed at preventing the practice of upcoding in Medicare Advantage, when healthcare providers bill for inaccurate codes ...
JD Supra

Aetna Agrees to Pay $117.7 Million to Settle False Claims Act Allegations Over Medicare Advantage Upcoding

Last summer, I wrote about the DOJ and HHS relaunching their joint False Claims Act Working Group, with Medicare Advantage risk adjustment fraud listed as one of its top enforcement priorities. The ...
Fierce Healthcare

Aetna to pay $117.7M to settle Medicare Advantage upcoding allegations: DOJ

Aetna has agreed to pay $117.7 million to settle allegations that it submitted false or inaccurate diagnoses to juice Medicare Advantage payments. Per an announcement from the Department of Justice, ...
KWQC

How to spot Medicare fraud and report it

DAVENPORT, Iowa (KWQC) - Federal officials are reminding Medicare users in Illinois and Iowa to watch for red flags and report suspected fraud. Here’s a quick to-do list to protect yourself: Then call ...
Townhall

Hospitals and Insurers Are Getting Rich Off Medical Fraud

Polls show Americans are angry – and rightly so – at accelerating medical bills. Meanwhile, the insurers and hospitals keep raking in record profits. UnitedHealthcare just reported jumbo profits so ...