Center for Medicare and Medicaid Services

A photo illustration shows four images separated by bars. The first image is of money and a Medicare card, the second is an older man sitting in a chair, the third is a closeup of money, the fourth is of a spreadsheet of overpayments totaling over $8 million.

Hidden audits reveal millions in overcharges by Medicare Advantage plans

5:01am November 21, 2022

Taxpayers footed the bill for care that should have cost far less, according to records released under the Freedom of Information Act. The U.S. government may charge insurers $650 million as a result.

The Biogen Inc., headquarters is shown in Cambridge, Mass. Medicare says it will limit coverage of a $28,200-per-year Alzheimer's drug whose benefits have been questioned.

Medicare proposes covering expensive Alzheimer's drug for those in clinical trials

7:55pm January 11, 2022

by Jonathan Franklin

Aduhelm is the first treatment approved in the country to slow cognitive decline in those living with Alzheimer's. Doctors have refused to prescribe it, given the lack of data and evidence behind it.

Medicare Advantage health plans have enrolled nearly 27 million members, or about 45% of people eligible for Medicare. A recent analysis finds Medicare overpaid the private health plans by more than $106 billion from 2010 through 2019 because of the way t

Medicare Advantage's cost to taxpayers has soared in recent years, research finds

5:00am November 11, 2021

by Fred Schulte

An alternative to original Medicare, the private plans are run mostly by major insurers. A recent analysis estimates Medicare overpaid these insurers by $106 billion from 2010 through 2019.

Medicare is funded by a combination of money paid directly to the federal government from paychecks and taxes paid by working Americans. Most dental procedures and tests are not covered under traditional Medicare.

Health & Safety

Democrats Hope To Beef Up Medicare With Dental, Vision And Hearing Benefits

2:49pm August 09, 2021

by Julie Rovner

When Medicare began in 1965, its backers expected benefits to expand over time, but politics have mostly stymied that. Congressional Democrats are trying again as part of a $3.5 trillion budget plan.

Medicare Advantage, a fast-growing private alternative to original Medicare, has enrolled more than 26 million people. Humana Inc. is one of the largest of these insurers. While popular with seniors, Medicare Advantage has been the target of multiple gove

Health & Safety

Humana Inc. Overcharged Medicare Nearly $200 Million, Federal Audit Finds

9:15am April 20, 2021

by Fred Schulte

If the report by the U.S. Department of Health and Human Services' Office of Inspector General is sustained, Humana Inc. could face a record penalty for overcharges in a Medicare Advantage plan.

Medicare's overhauled Plan Finder debuted at the end of August. But health care advocates and insurance agents say the website has had big problems ever since, including inaccurate details about prices, which drugs each plan covers and their dosages.

Health & Safety

Will Glitches In Medicare's 'Plan Finder' Leave Some Seniors Stuck In The Wrong Plan?

8:19pm December 06, 2019

by Susan Jaffe

With a deadline for Medicare enrollment looming, some lawmakers and advocates are concerned that Medicare hasn't done enough to reach out to consumers who might be affected by website problems.

Colorado estimates that about 15% of the 12 million letters it sends to beneficiaries of public assistance programs each year are returned unopened, left to pile up in county offices like this one in Colorado Springs. That amounts to about 1.8 million pie

Return To Sender? Just One Missed Letter Can Be Enough To End Medicaid Benefits

5:00am November 01, 2019

by Markian Hawryluk

Colorado, like a number of states, is struggling with huge piles of returned mail linked to public aid programs such as Medicaid or food stamps. But is dropping people from such assistance the answer?

Medicare Advantage health plans, mostly run by private insurance companies, have enrolled more than 22 million seniors and people with disabilities — more than 1 in 3 people who are on some sort of Medicare plan.

Journalists File Lawsuit To Force Feds To Release Medicare Advantage Audits

12:59pm September 27, 2019

by Fred Schulte

A lawsuit filed by Kaiser Health News under the Freedom of Information Act could spur the Centers for Medicare & Medicaid Services to release audits that document up to $650 million in overcharges.

In rugged, rural areas, patients often have little choice about how they'll get to the hospital in an emergency. "The presence of private equity in the air ambulance industry indicates that investors see profit opportunities," a 2017 report from the feder

Wyoming Wants To Use Medicaid To Reduce Air Ambulance Bills For All Patients

12:57pm August 23, 2019

by Markian Hawryluk

Frustrated with sky-high bills from air ambulance companies, Wyoming hopes to hammer down those charges with more regulation. The companies say such a proposal undermines free enterprise.

If a doctor is found to be ordering too many MRI or CT scans or other imaging tests for Medicare patients, a federal law is supposed to require the physician to get federal approval for all diagnostic imaging. But the Trump administration has stalled the

Health & Safety

Trump Team Hits Brakes On Law That Would Curb Unneeded Medicare CT Scans, MRIs

11:05am August 09, 2019

by Phil Galewitz

Critics worry that the administration's delays come at a steep cost: Medicare continues to pay for millions of unnecessary exams and patients are being subjected to radiation for no medical benefit.