Six years ago an initial round of audits found that Medicare had potentially overpaid five of the health plans $128 million in 2007 alone. This all deals with the Medicare Advantage Plans. In the end, how much did they settle the audits for in 2012? Just under $3.4 million.
Personally, I think this proves a couple of points. One, it shows how impotent or poorly run the government is, in regards to healthcare. But heck, it’s your money and not theirs so they don’t care. Second, it shows that they cannot pin anything to those doctors who “upcode” to charge Medicare more money. The whole coding system is a joke. You have heard of the ICD-10 debacle but this is different. The way doctors code is to add as much fluff to the medical chart to make it sound more than it is. With the help of the EMR it is very easy and a total scam. Each little bit of information makes the documentation more worthy of a higher bill albeit less valuable to anyone reading it.
You can read the article linked about and see how the story turned (fizzled) out. Nothing will be done. Another loss for our tax dollars. Can’t we just have a system with transparent costs? It really isn’t that hard. The one we have now doesn’t work. In my opinion, if these Medicare patients were told of the price of their services prior to receiving them and had to pay it themselves then this would be another story altogether. No group of patients complain and haggle harder than the elderly.