MedPage Today September 2, 2024
— “CMS made a complete boondoggle out of this,” one expert said
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 showed.
The Centers for Medicare & Medicaid Services (CMS) published the draft regulation in January 2014. The rule would have required health plans, when examining patients’ 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.
The 2014 decision...
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