How Medicare Advantage plans dodged auditors and overcharged taxpayers by millions

A review of 90 government audits, released exclusively to KHN in response to a Freedom of Information Act lawsuit, reveals that some health insurers issuing Medicare Advantage plans have tried to sidestep regulations requiring them to document medical conditions the government paid them to treat.

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.

(Image credit: Lydia Zuraw/KHN)

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Fred Schulte