HHS sued over Medicare Advantage audit records

KFF Health News is suing HHS to release audits of Medicare Advantage plans and other records, the health news outlet reported Nov. 12. 

Advertisement

The lawsuit is seeking correspondence between HHS officials and Medicare Advantage plans related to overpayment audits and financial penalties, according to KFF Health News. 

The outlet is also seeking copies of government contracts awarded to firms conducting audits of MA plans. 

In 2019, the outlet sued to compel HHS to release audits of MA plans. In 2022, the agency published summaries of 90 audits, which examined billings from 2011 to 2013. 

HHS did not provide comment to KFF Health News. 

Nearly every Medicare Advantage plan has faced or settled allegations of upcoding, making patients appear sicker on paper to receive more reimbursement from the federal government. HHS’ Office of Inspector General has published overpayment audits of four Medicare Advantage plans in recent months. 

Read more here.

At the Becker's 5th Annual Fall Payer Issues Roundtable, taking place November 17–19 in Chicago, payer executives and healthcare leaders will come together to discuss value-based care, regulatory changes, cost management strategies and innovations shaping the future of payer-provider collaboration. Apply for complimentary registration now.

Advertisement

Next Up in Payer

Advertisement

Comments are closed.