Insurance Companies Get Away with Overbilling Medicare

Yesterday's New York Times reported:

"Private insurance companies participating in Medicare have been allowed to keep tens of millions of dollars that should have gone to consumers, and the Bush administration did not properly audit the companies or try to recover money paid in error....

"The investigators, from the Government Accountability Office, said the money could have been used to reduce premiums or provide additional benefits to older Americans.

"Under federal law, Medicare officials are supposed to audit the financial records of at least one-third of the insurance companies each year. But the investigators said the Bush administration had fallen far short of that goal and had never met the 'statutory requirement.'

"Indeed, they said, the proportion of companies audited by Medicare declined steadily - to 14 percent in 2006 from 24 percent in 2001 - despite a steady growth in Medicare payments to the plans. Those payments now total $75 billion a year, about one-fifth of all Medicare spending....

"In 2003, Medicare audited 49 of the 220 organizations participating in the program. Auditors found significant errors at 41 companies, but Medicare officials took no action on the findings. As a result of the errors, the auditors said, insurers kept '$59 million that beneficiaries could have received in additional benefits, lower co-payments or lower premiums.'"

Wow -- 83% of the audited insurance companies made "errors."  How much money would be found if all participating insurers were audited?

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Comments

[commercial insurance quotes]

Over billing Medicare is a thing of the past. The new insurance companies have more awareness and adjust the insurance plan better for its audience. A lot of progress have been made in this specific area.