Oz Intensifies Spotlight on Medicare Insurers’ Payments Practice

President Donald Trump’s nominee to lead the Medicare agency is joining regulators, lawmakers, and a host of policy watchers in calling for continued scrutiny of Medicare managed care plans’ practice of exaggerating patient diagnoses in order to receive higher payments.

“Upcoding” by “scoundrel” Medicare Advantage plans is “cheating” taxpayers and shaking the confidence of MA program administrators and beneficiaries who “should all feel the system’s working for them,” Mehmet Oz testified in his confirmation hearing before the Senate Finance Committee on March 14.

Upcoding, or “coding intensity,” is projected to increase the cost of care for beneficiaries in MA ...