Becker's Healthcare October 23, 2023
The Cigna Group will pay over $170 million to settle allegations of Medicare Advantage fraud, and government watchdogs are auditing other plans for potential overpayments.
Nearly every major insurer has been accused of or settled allegations of receiving Medicare Advantage overpayments through upcoding, or making patients appear sicker than they are on paper to receive higher reimbursements from the government.
Here are four insurers audited for MA overpayments or settling allegations of fraud Becker’s has reported since July.
- Aetna received $632,070 in overpayments for Medicare Advantage claims from 2015 to 2016, an audit from HHS’ Office of Inspector General found. The OIG used the audit sample to estimate the insurer received at least $25.5 million in...
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