Medicare Paid Insurers Billions for Questionable Home Diagnoses, Watchdog Finds

October 24, 2024

black and white image of a stethoscope

(Wall Street Journal) – Private Medicare insurers got about $4.2 billion in extra federal payments in 2023 for diagnoses from home visits the companies initiated, even though they led to no treatment, a new inspector general’s report says.

The extra payments were triggered by diagnoses documented based on the visits, including potentially inaccurate ones, for which patients received no other medical services, the report says. Insurers offering private plans under Medicare, known as Medicare Advantage, are paid more when patients have costly conditions. (Read More)