Becker's Healthcare August 5, 2024
Insurers made billions from diagnoses added to Medicare Advantage beneficiaries’ charts during home visits, The Wall Street Journal found in an investigation published Aug. 5.
Previous reporting from the Journal found that MA insurers made $50 billion from diagnoses added to patients charts between 2018 and 2021. Many of these diagnoses were “questionable,” according to the Journal.
Around a third of these diagnoses were added during home visits, the Journal reported. The federal government pays Medicare Advantage plans a rate per beneficiary based on their diagnoses.
In one example, more than 700,000 diagnoses of peripheral artery disease were made during home visits to MA beneficiaries in 2019 to 2021, totaling $1.8 billion in payments for insurers.
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