STAT+: Medicare Advantage insurers will score $2 billion gift thanks to limited audits
Medicare officials made a clear statement four years ago about how best to audit the country’s Medicare Advantage insurers: Failing to take back all overpayments “would be contrary to the public interest.”
But based on a final regulation published Monday, Medicare is going against that public interest by giving a free pass to Medicare Advantage plans for any erroneous codes they submitted between 2011 and 2017. The amount of taxpayer money that insurers will get to keep because of that decision: $2 billion.
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