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Humana Inc. Overcharged Medicare Nearly $200 Million, Federal Audit Finds

Added 04-20-21 12:07:02am EST - “If the report by the U.S. Department of Health and Human Services' office of inspector general is sustained, Humana Inc. could face a record penalty for overcharges in a Medicare Advantage plan.” - Npr.org

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Posted By TheNewsCommenter: From Npr.org: “Humana Inc. Overcharged Medicare Nearly $200 Million, Federal Audit Finds ”. Below is an excerpt from the article.

Medicare Advantage, a fast-growing private alternative to original Medicare, has enrolled more than 26 million people. Humana Inc. is one of the largest of these insurers. While popular with seniors, Medicare Advantage has been the target of multiple government investigations. Pablo Martinez Monsivais/AP hide caption

Medicare Advantage, a fast-growing private alternative to original Medicare, has enrolled more than 26 million people. Humana Inc. is one of the largest of these insurers. While popular with seniors, Medicare Advantage has been the target of multiple government investigations.

A Humana Inc. health plan for seniors in Florida improperly collected nearly $200 million in 2015 by overstating how sick some patients were, according to a new federal audit, which seeks to claw back the money.

The Health and Human Services Office of Inspector General's recommendation to repay, if finalized, would be "by far the largest" audit penalty ever imposed on a Medicare Advantage company, said Christopher Bresette, an HHS assistant regional inspector general.

Humana sharply disputed the findings of the audit, which was set for public release Tuesday. A spokesman for the company said Humana will work with Medicare officials "to resolve this review," and noted the recommendations "do not represent final determinations, and Humana will have the right to appeal."

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