doctor with female patient

Former executive alleges that insurance companies are overcharging Medicare.

A whistle-blower has charged that insurers have used the Medicare Advantage program to make billions of dollars to which they were not entitled, according to The New York Times in “A Whistle-Blower Tells of Health Insurers Bilking Medicare.”

The federal government may need to do something to fix Medicare or risk running out of available funds for the program. One recent attempt to fix Medicare was undertaken in the early 2000s and is now known as Medicare Advantage.

The program privatized parts of Medicare by turning things over to insurance companies. The idea was that insurers would do a better job of controlling costs in the program than the government.

However, it has been charged that insurers used the medical coding system to make patients look sicker than they really are. As a result, the insurers easily collect more money from the government than they actually should.

The government has already announced plans to sue one insurer, based on these allegations and more lawsuits against other companies are expected.

It is important for the government to stop this fraud, if true, and any other Medicare fraud.

Reference: New York Times (May 15, 2017) “A Whistle-Blower Tells of Health Insurers Bilking Medicare.”

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