10 payers audited for Medicare Advantage overpayments in 2023

OIG audits found over $213 million in estimated Medicare Advantage overpayments in 2023. 

According to the agency's fall semiannual report, the agency issued 65 audits with an expected $82.7 million in recoveries between April and September 2023. 

The agency did not request the full estimated repayment amounts from the MA plans it audited in 2023 because of a CMS ruling that prevents the agency from extrapolating payments before contract year 2018. 

Here are 10 plans audited by CMS in 2023: 

  1. Geisinger Health Plan
    Received an estimated $6.5 million in overpayments in 2016 and 2017. 

  1. MCS Advantage 
    Received an estimated $6.2 million in net overpayments in 2016 and 2017. 

  1. Cigna HealthSpring Life & Health Insurance Company
    Received an estimated $6.24 in estimated overpayments in 2016 and 2017. 

  1. HumanaChoice 
    Received an estimated $27.3 million in net overpayments in 2015 and 2016. 

  1. Keystone Health Plan East (Independence Blue Cross) 
    Received an estimated $11.3 million in overpayments in 2016 and 2017. 

  1. Excellus Health Plan 
    Received an estimated $5.4 million in overpayments in 2017 and 2018. 

  1. Presbyterian Health Plan 
    Received an estimated $2.2 million in overpayments in 2017 and 2018. 

  1. Aetna 
    Received an estimated $25.5 million in overpayments in 2015 and 2016. 

  1. CarePlus Health Plans (Humana) 
    Received an estimated $117.3 million in overpayments in 2015. 

  1. SelectCare of Texas (Centene) 
    Received an estimated $5.1 million in overpayments in 2015 and 2016. 

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