Watchdog says Humana MA plan was overpaid by as much as $27.3 millionPosted On: Apr. 25, 2023 10:18 AM CST
Humana Inc.’s Medicare Advantage plan, HumanaChoice, received an estimated $27.3 million in overpayments in 2015 and 2016, according to a federal audit, reports Becker’s Payer Issues. The audit by the Department of Health and Human Services’ Office of Inspector General sampled 210 enrollee-years for high-risk diagnosis codes. OIG's audit found $480,295, which the agency requested Humana repay. The agency did not request the total amount of estimated overpayments for the audit period, because of a recent ruling that audit findings cannot be extrapolated past 2018.