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Medicare Fraud
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Feds expect to collect $4.7B in insurance fraud penalties

The Biden administration is estimating that it could collect as much as $4.7 billion from insurance companies with newer and tougher penalties for submitting improper charges on the taxpayers’ tab for Medicare Advantage care

By AMANDA SEITZ
Published - Jan 30, 2023, 06:45 PM ET
Last Updated - Jun 23, 2023, 12:11 AM EDT

WASHINGTON (AP) — The Biden administration estimated Monday that it could collect as much as $4.7 billion from insurance companies with newer and tougher penalties for submitting improper charges on the taxpayers' tab for Medicare Advantage care.

Federal watchdogs have been sounding the alarm for years about questionable charges on the government's private version of the Medicare program, with investigators raising the possibility that insurance companies may be bilking taxpayers of billions of dollars every year by claiming members are sicker than they really are to receive inflated payments.

The Department of Health and Human Services said it will begin collecting payments from insurers when an audit turns up that they charged for diagnoses that are not reflected in the patient's medical records. The government has not sought refunds for those payments in over a decade, the agency said.

“Today, we are taking some long overdue steps to move us in the direction of accountability,” HHS Secretary Xavier Becerra said Monday during a phone call with reporters.

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