A new Medicare regulation will aggressively audit advantage plans for indications of overbilling the biden administration has announced a new rule designed to crack down
in Medicare private plans that have allowed insurance companies to overcharge the U
S. Government. The regulation is seeking a more aggressive approach to auditing the Medicare advantage programs Plans
The Medicare advantage program enrolls almost 50% of all the beneficiaries of Medicare
According to the biden administration, it is expecting to recoup as much as $4.7 billion from insurance companies that have overcharged the federal government over
the last 10 years. This new oversight is also expected to act as a deterrent against future overpayments
This represents the strongest action the us government has taken against overbilling in over 10 years
The new rule provides the government with the ability to conduct a more thorough audit
after which it can recover funds from overpayments. Medicare has faced heavy criticism for failing to defend itself from overcharges from insurance companies
Health and human services Secretary Xavier Becerra announced the change at a news conference there acknowledged that Medicare has experienced considerable criticism
for its weak stance against the ongoing issue of overcharging plans. Today
we are taking some long overdue steps to move us in the direction of accountability
said Viscera at the conference, Medicare advantage has been growing in popularity in recent years
particularly among older americans said Viscera. As a result, he said, it is important for the agency to be certain that the private plans have
proper oversight. We want to encourage correct reporting across the program. Health insurance companies have been heavily lobbying against the rules policies as they relate
to a risk adjustment system. Therefore, it is expected that insurers will be filing legal actions against the federal government to fight the change the
Sarah state, that he would not be able to speculate on the size or nature of any possible litigation
but he underscored that he felt that the newly announced rule was ready for prime time
This rule is unlawful and fatally flawed and it should have been withdrawn instead of finalized
said large insurer trade group of hips President Matt Eyles in a prepared statement
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