In a civil suit filed this week, the Justice Department accuses a New York medical analytics company of helping a Medicare Advantage plan cheat taxpayers out of millions of dollars.
If the report by the U.S. Department of Health and Human Services' Office of Inspector General is sustained, Humana Inc. could face a record penalty for overcharges in a Medicare Advantage plan.
As the Trump administration calls for expanding access to Medicare Advantage, a federal whistleblower lawsuit accuses a large Medicare Advantage plan of bilking Medicare out of $8 million.
Officials warn that schemes devised to steal from Medicare have embraced telemedicine. One man was prescribed $4,000 of medical equipment he didn't need and never asked for.
Doctors, lab technicians and telemarketers from around the U.S. were among those arrested in the investigation of a scheme that the DOJ alleges defrauded seniors and Medicare.
A lawsuit filed by Kaiser Health News under the Freedom of Information Act could spur the Centers for Medicare & Medicaid Services to release audits that document up to $650 million in overcharges.
A federal audit and a whistleblower lawsuit allege that Medicare Advantage plans from the St. Louis-based Essence Group Holdings Corp. have significantly overcharged taxpayers.
Medicare pays more than $16 billion a year for hospice services. But a new report from the Department of Health and Human Services says hospice patients don't always get the care they're promised.
RENO, Nev. (AP) — The operator of the largest hospital and health care network in northern Nevada has agreed to pay the Justice Department $9.5 million to settle allegations of patient-overcharging and Medicare fraud.
Medicare Advantage health plans are privately run, but reimbursed by Medicare. A Texas lawsuit claims that, to inflate charges, 30 Advantage plans in 15 states exaggerated how sick patients were.
More than 1,400 pharmacies billed for questionable prescriptions last year, according to the inspector general at Health and Human Services. That includes prescriptions for commonly abused opioids.
One doctor alone is accused of causing nearly $23 million in fraud losses, including "over 1,000 expensive power wheelchairs ... that were not medically necessary and often not provided."
The federal government overpaid for nearly half of the patients of a Medicare Advantage plan, a Medicare audit found. At issue is whether insurers "upcode" diagnoses to reap bigger payments.
