Thursday, April 22, 2021

Humana Inc. Overcharged Medicare Nearly $200 Million, Federal Audit Finds

 



Here is something that those of you in healthcare may find hard to believe (please not sarcasm in preceding sentence).  It seems that Humana, who strings along providers with supposed need for more and more information before they pay a claim, at the same time has been seriously overcharging the federal government's Medicaid Program.

Insurance companies have become more and more difficult to deal with and it has become harder and harder to get even simple claims paid on a timely basis... and Humana is definitely NO exception to that rule.  Being in the dental profession, I've always found it interesting that there are delays in paying and often accusations of unneeded treatment from companies that are often pocketing tens of millions of dollars from taxpayers in overcharges and overbilling for unneeded treatment.  Oh, and all of this money was received for patients in *one state*.  Florida, to be exact.

Is it just me or does that seem ironic to everyone?  I thought so.

Now, I understand and support processes and systems that keep things and people honest.  Trust, but verify is the smartest and most reliable way to do things.  My anger boils when  my office struggles to be paid for a $400 procedure while Humana, in ONE state, is overbilling 200 million dollars.  The numbers probably won't work out in the following example, but just to put this in perspective... if Humana is overcharging 200 million in one state, then with their being 50 states, that means 200,000,000 x 50=  $10,000,000,000 which is 10 billion (with a B).

There is a great story on this issue over at NPR.com.  Head on over and check it out!   


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