Fred Schulte

Medicare suddenly stopped paying for the pricey drug that prolongs his life. As he waits for an appeal, this retired physician wonders if he should give up treatment to spare his family the cost.

A KHN investigation found when some Medicare Advantage plans got a rare federal audit, they couldn’t produce billing records for care they said they’d provided. Some blamed fire, flood — or doctors.

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.

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.

In a civil suit filed this week, the Justice Department accuses a New York medical analytics company and two consultants of helping health plans for seniors cheat Medicare out of millions of dollars.

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.

As the Trump administration calls for expanding access to Medicare Advantage, a federal whistleblower lawsuit accuses a large Medicare Advantage plan of bilking Medicare out of $8 million.

As the Trump administration calls for expanding access to Medicare Advantage, a federal whistleblower lawsuit accuses a large Medicare Advantage plan of bilking Medicare out of $8 million.

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.

The federal government wants to deploy several new tools for catching insurers that have overcharged Medicare $30 billion in last three years alone. But the insurance industry is balking.