Medicare Advantage

A whistleblower suit against Humana Inc. alleges the insurer turned a blind eye to billing fraud involving Medicare patients. People were diagnosed with more serious ailments than they actually had.

Iowa Sen. Charles Grassley says the federal government has to "get it right" and pursue full refunds for overpayments to companies that offer Medicare Advantage health insurance.

Drug plans offered by private insurers under Medicare change from year to year. It pays to check around for the best deal during open enrollment season.

Improper payments by Medicare and Medicaid are wasting billions of dollars a year, the White House budget director said. He called for urgent corrective action in a letter that is now public.

Medicare Advantage health plans are privately run, but reimbursed by Medicare. A Texas lawsuit claims that, to inflate charges, 30 Advantage plans in 15 states exaggerated how sick patients were.

Internal audits, never before made public, provide striking evidence of billing mistakes in Medicare Advantage health plans. The Center for Public Integrity filed suit to obtain the records.

The federal government overpaid for nearly half of the patients of a Medicare Advantage plan, a Medicare audit found. At issue is whether insurers "upcode" diagnoses to reap bigger payments.

Iowa Republican Sen. Chuck Grassley is asking the Obama administration pointed questions about what is being done to investigate alleged fraud, waste and abuse by Medicare Advantage plans.

When the Centers for Medicare and Medicaid Services sent a memo to insurers saying government audit policies could be relaxed, investors privy to the news pounced, sending shares upward.

An unpublished government study from 2009 sounded alarm bells about the risk formula used to pay privately run Medicare insurance plans. Since then billions of dollars in waste have been documented.