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.
Government Watchdogs Attack Medicare Advantage for Denying Care and Overcharging
The Government Accountability Office and the Health and Human Services inspector general’s office say seniors enrolled in the program are suffering and taxpayers are getting bilked for billions of dollars a year.
With its latest venture into primary care clinics, is America’s leading organization for seniors selling its trusted seal of approval?
Federal Investigation Into Spine Surgeries Uses Mob Laws to Target Health Care Fraud
Investigators allege a Texas company that arranges spine surgery and other medical care for people injured in car crashes accepted bribes in violation of 1960s-era racketeering law.
The letters function as liens that “protect” spine surgery clinics while patients could be left with inflated medical bills and unexpected health risks.
Researcher: Medicare Advantage Plans Costing Billions More Than They Should
Some insurers pocketed ‘eye-popping’ overpayments, billing records show.
Justice Department Targets Data Mining in Medicare Advantage Fraud Case
The feds’ civil suit links exaggerated patient bills to “tens of millions” in overcharges.