President Trump’s Medicare agency is on a mission to speed up audits of Medicare Advantage insurers, aiming to recover about $500 million annually for taxpayers. However, these audits are currently tangled up in a legal battle with Humana, throwing a wrench into the administration’s plans. The Centers for Medicare and Medicaid Services announced that they will be hiring close to 2,000 additional coders by September in an effort to use advanced technology systems to review data. The goal is to ensure that the diagnoses submitted by Medicare Advantage insurers are backed up by patients’ medical records, though the specific technology to be used was not disclosed.
The lawsuit initiated by Humana has put a damper on the Trump administration’s efforts to expedite audits, creating uncertainty around how the new strategy will be implemented. With the hiring of additional coders and the promise of advanced technology systems, the Centers for Medicare and Medicaid Services are gearing up for a thorough review of data to crack down on potential discrepancies in submitted diagnoses. While the details of the technology remain unknown, the agency is forging ahead with its plans to increase scrutiny on Medicare Advantage insurers.
As the legal battle continues to unfold, the Trump administration remains steadfast in its pursuit to ensure that taxpayer dollars are not being misused by Medicare Advantage insurers. The addition of nearly 2,000 coders and the promise of advanced technology systems signal a proactive approach by the Centers for Medicare and Medicaid Services to uphold the integrity of the Medicare program. Despite the ongoing litigation with Humana, the agency is moving forward with its audit plans, underscoring the importance of transparency and accountability in the healthcare industry. The road ahead may be bumpy, but the administration is committed to seeing these audits through to completion.
