6 Medicare Advantage plans audited for upcoding in the last six months

Audits published in the last six months found almost $32 million in overpayments across six Medicare Advantage plans, according to HHS' Office of Inspector General's semiannual report to Congress. 

The report, published June 2, summarizes audits the office published between October 2022 and March 2023. 

Here are the Medicare Advantage plans the agency audited during that time: 

  1. Blue Cross and Blue Shield of Rhode Island received an estimated $4.8 million in overpayments between 2016 and 2017. 
  2. California Physicians Services, a Blue Shield of California plan, received an estimated $2 million in overpayments in 2016 and 2017. 
  3. Cigna HealthSpring of Tennessee received an estimated $5.9 million in overpayments in 2016 and 2017. 
  4. Geisinger Health Plan received an estimated $6.8 million in overpayments in 2016 and 2017. 
  5. MCS Advantage, a Puerto Rico-based plan, received an estimated $6.2 million in overpayments in 2016 and 2017.
  6. CignaHealthSpring Life & Health Insurance Company received an estimated $6.24 million in overpayments in 2016 and 2017.  

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