Senator Chuck Grassley, R-Iowa, is calling for a federal investigation into payers allegedly overcharging Medicaid Advantage plans, HealthPayerIntelligence reports.
Here's what you should know.
1. Mr. Grassley wrote CMS Administrator Seema Verma, citing an improper $125 million payout to a payer, calling it "low" and the "tip of the iceberg."
2. HealthPayerIntelligence reports from 2008 to 2013 Medicaid Advantage programs were allegedly involved with a $70 billion payment manipulation scandal.
3. Mr. Grassley also asked the government what officials was doing to prevent fraudulent Medicare billing, and if the government conducted/is conducting any audits into CMS.
4. Mr. Grassley wrote a similar letter to CMS in 2015 taking aim at its alleged faulty risk score alterations.