Insurers Pocketed $50 Billion From Medicare for Diseases No Doctor Treated (The Wall Street Journal)

Medicare Advantage insurers, like UnitedHealth, have been found to add questionable and often false diagnoses to patient records to increase payments from Medicare. These diagnoses, such as diabetic cataracts, were frequently not supported by patients’ medical histories and resulted in billions of dollars in extra costs. The Wall Street Journal’s investigation highlighted that many patients were unaware of these diagnoses, which often contradicted their doctors’ records. This practice has raised concerns about the accuracy and ethics of the Medicare Advantage program. Could this lead to significant reforms in Medicare’s payment systems?