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Employee Benefits

Auditors say Humana owes $34 million in Medicare Advantage overpayments

October 05, 2022 Reprints

Federal auditors are calling for Humana Inc. to refund $34.4 million in alleged overpayments made to the payer's HumanaChoice Medicare Advantage plan in 2016 and 2017, Healthleaders Media reports. The Department of Health and Human Services Office of the Inspector General, examined "nine high-risk groups" billed by HumanaChoice in 2016 and 2017 and found that 207 out of 270 (76%) randomly selected diagnosis codes "were not supported in the medical records and resulted in $574,430 of overpayments for the 270 enrollee-years.”

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Auditors say Humana owes $34 million in Medicare Advantage overpayments

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