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Humana health plan overcharged Medicare by nearly $200 million, federal audit finds 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. "This [money] needs to come back to the fe...

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) 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 r...

Humana misrepresented Medicare Advantage costs by $200 million, OIG says Print Humana should return nearly $200 million to CMS after overcharging the federal agency for care that its Medicare Advantage enrollees did not need, according to a recent government report. The Louisville, Ky.-based insurer overcharged CMS by $197.7 million in 2015, representing the largest gap between what a Medicare Advantage payer said its members' care cost and the actual price of the care received, an HHS' Office of Inspector General analysis of diagnosis claims revealed. As enrollment in Medicare Advantage plan...