CA health plan may have overbilled Medicare $424M

California Watch, December 18, 2012
Medicare may have overpaid an estimated $424 million to PacifiCare of California's Medicare Advantage plan based on risk assessments that in many cases made patients seem sicker than they were, according to a federal oversight agency. Medicare Advantage plans send patient diagnosis codes to Medicare, which boosts plan rates if clients are affected by serious medical conditions. A new report by the U.S. Health and Human Services inspector general says PacifiCare was paid extra for treating patients with cancer or a dangerous bloodstream infection even though medical records didn't describe those ailments.

MOST POPULAR

SPONSORED REPORTS
SPONSORED HEADLINES

SIGN UP

FREE e-Newsletters Join the Council Subscribe to HL magazine

SPONSORSHIP & ADVERTISING

100 Winners Circle Suite 300
Brentwood, TN 37027

800-727-5257

About | Advertise | Terms of Use | Privacy Policy | Reprints/Permissions | Contact
© HealthLeaders Media 2015 a division of BLR All rights reserved.