Feds Killed Plan To Curb Medicare Advantage Overbilling After Industry Opposition

(By Fred Schulte for KFF Health News)

A decade ago, federal officials drafted a plan to discourage Medicare Advantage health insurers from overcharging the government by billions of dollars — only to abruptly back off amid an “uproar” from the industry, newly released court filings show.

The Centers for Medicare & Medicaid Services published the draft regulation in January 2014. The rule would have required health plans, when examining patient’s medical records, to identify overpayments by CMS and refund them to the government.

But in May 2014, CMS dropped the idea without any public explanation. Newly released court depositions show that agency officials repeatedly cited concern about pressure from the industry. Continue reading here…

Kaiser Health News is a nonprofit national health polity news service that is part of the nonpartisan Henry J. Kaiser Family Foundation

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