KHN sues CMS to release audits that may reveal millions in overcharges by Medicare Advantage health plans

“Kaiser Health News is suing the U.S. Centers for Medicare & Medicaid Services to release dozens of audits that the agency says reveal hundreds of millions of dollars in overcharges by Medicare Advantage health plans.”

“The suit, filed late Thursday in U.S. District Court in San Francisco under the Freedom of Information Act, seeks copies of 90 government audits of Medicare Advantage health plans conducted for 2011, 2012 and 2013 but never made public. CMS officials have said they expect to collect $650 million in overpayments from the audits. Although the agency has disclosed the names of the health plans under scrutiny, it has not released any other details…:

“On July 3, KHN reporters filed a FOIA requesting copies of the CMS audits, which are known as Risk Adjustment Data Validation, or RADV, and include the audit spreadsheets, payment error calculations and other records. CMS has yet to respond to that request, according to the suit…” Read the full article here.

Source: KHN Files Lawsuit To Force Feds To Disclose Medicare Advantage Audits – By Fred Schulte, September 27, 2019. Kaiser Health News.

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