Medicare Advantage insurers collected billions of dollars in dubious payments by diagnosing patients with conditions for which they received no follow-up care.
UnitedHealth was top insurer collecting billions in questionable Medicare payments, federal watchdog finds
By Casey Ross, Tara Bannow, Lizzy Lawrence, and Bob Herman
Adobe
Medicare Advantage insurers collected billions of dollars in dubious payments from Medicare by using home visits and medical chart reviews to diagnose patients with conditions for which they received no follow-up care, a federal watchdog found.
Insurers led by UnitedHealth Group collectively received an estimated $7.5 billion in payments last year from health risk assessments and related reviews of medical records performed in 2022.
The diagnoses added during those assessments were not found in any of the patients' other medical records that year, suggesting that they were either inaccurate or that patients did not get potentially necessary care for serious conditions, the watchdog found.
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