Geisinger Health Plan received $6.5M in Medicare Advantage overpayments, OIG audit finds

Geisinger Health Plan received $6.5 million in Medicare Advantage overpayments in 2016 and 2017, according to an audit from HHS' Office of the Inspector General. 

The audit, published March 20, reviewed high-risk diagnosis codes between 2016 and 2017. The agency found $566,476 in overpayments in its sample, which it used to estimate the health plan received $6.5 million in overpayments between 2016 and 2017. 

Geisinger disagreed with all of CMS' findings and recommendations, according to the report. 

The agency recommended the health plan repay $566,476 to the federal government, rather than the estimated $6.5 million, because of a recent CMS ruling that audit findings cannot be extrapolated beyond 2018. 

The OIG released audits of nine other Medicare Advantage plans in the last six months of 2022, according to the organization's semiannual report to Congress. 

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