medicare advantage

The former medical director of two Florida insurance plans owned by the same company alleged they inflated fees by making patients appear sicker than they were or exaggerating the treatment provided.

Federal audits of 37 Medicare Advantage health plans cited 35 for overbilling the government. Many plans, for example, claimed patients with depression or diabetes were sicker than they actually were.

Privately run Medicare Advantage plans have overcharged the federal government by billions of dollars, yet Medicare hasn't been effective in recouping the excessive payments, an audit found.

Cuts in provider networks spurred Medicare officials to allow more than 15,000 Medicare Advantage members to pick new plans in seven states, the District of Columbia and Puerto Rico.