UnitedHealth Wins Ruling Over $2B in Alleged Medicare Advantage Overpayments
A special master found the Justice Department failed to prove wrongdoing by the giant health insurer.
In Settling Fraud Case, New York Medicare Advantage Insurer, CEO Will Pay up to $100M
A whistleblower suit alleged a health insurer bilked Medicare by exaggerating how sick patients were.
Federal Watchdog Urges Crackdown on Medicare Advantage Home Visits
Medicare officials are pushing back against a federal watchdog’s call to crack down on home visits by Medicare Advantage health plans — a practice the watchdog says may waste billions of tax dollars every year. In late October, a Health and Human Services inspector general audit found that the insurers pocketed $7.5 billion in 2023 from diagnosing health conditions that […]
KFF Health News Sues To Force Disclosure of Medicare Advantage Audit Records
Freedom of Information Act case targets HHS inspector general’s reviews of billions of dollars in health plan overpayments.
Watchdog Calls for Tighter Scrutiny of Medicare Advantage Home Visits
Medicare officials defend the use of home visits that often spot medical conditions that are never treated.
Florida Medical Device Maker Exactech Declares Bankruptcy
The company faces more than 2,000 lawsuits alleging it sold defective knee and hip implants.
The Medicare Advantage Influence Machine
New court filings and lobbying reports reveal an industry drive to tamp down critics — and retain billions of dollars in overcharges.
Feds Killed Plan To Curb Medicare Advantage Overbilling After Industry Opposition
A private 2014 decision by the Centers for Medicare & Medicaid Services faces new scrutiny in a multibillion-dollar Justice Department fraud case against UnitedHealth Group.
Nursing Homes Wield Pandemic Immunity Laws To Duck Wrongful Death Suits
More than 172,000 nursing home residents died of covid. In lawsuits, some families who lost loved ones say they were misled about safety measures or told that covid wasn’t a danger in their facilities.
Whistleblower Accuses Aledade, Largest US Independent Primary Care Network, of Medicare Fraud
A recently unsealed lawsuit alleges Aledade Inc. developed billing software that boosted revenues by making patients appear sicker than they were.
Deep Flaws in FDA Oversight of Medical Devices, and Patient Harm, Exposed in Lawsuits and Records
Thousands of medical devices are sold, and even implanted, with no safety tests.
Thousands Got Exactech Knee or Hip Replacements. Then, Patients Say, the Parts Began to Fail.
In a torrent of lawsuits, patients accuse Florida device maker Exactech of hiding knee and hip implant defects for years. The company denies the allegations.
Lose Weight, Gain Huge Debt: NY Provider Has Sued More Than 300 Patients Who Had Bariatric Surgery
The private equity-backed practice has been known to demand more than $100,000 in charges or penalties. One patient is fighting back.
When Medicare stops paying for a pricey drug that prolongs life, an Ohio man considers giving up treatment to spare his family enormous debt.
Government Lets Health Plans That Ripped Off Medicare Keep the Money
In a surprise decision, U.S. officials yield to insurance industry demands — at least for now.
Did Your Health Plan Rip Off Medicare?
KHN has released never-before-seen details of federal audits as the government weighs action against dozens of Medicare Advantage plans.
How Medicare Advantage Plans Dodged Auditors and Overcharged Taxpayers by Millions
Facing rare scrutiny from federal auditors, some Medicare Advantage health plans failed to produce any records to justify their payments, government records show. The audits revealed millions of dollars in overcharges to Medicare over three years.
Audits — Hidden Until Now — Reveal Millions in Medicare Advantage Overcharges
Taxpayers had to foot the bills for care that should have cost far less, according to records released after KHN filed a lawsuit under the Freedom of Information Act. The government may seek to recover up to $650 million as a result.
Private equity firms have shelled out almost $1 trillion to acquire nearly 8,000 health care businesses, in deals almost always hidden from federal regulators. The result: higher prices, lawsuits, and complaints about care.
Lawsuit by KHN Prompts Government to Release Medicare Advantage Audits
The lawsuit was filed three years ago to learn about vast overcharges by the popular health plans that are detailed in audits the government refused to release to the public.
