Fred Schulte

Insurance giant Humana Inc., which operates some of the nation's largest private Medicare health plans, knew for years of billing fraud at some South Florida clinics but did little to curb the practice even though it could harm patients, a doctor alleges in a newly unsealed whistleblower lawsuit.

The suit ...

Despite facing mounting evidence federal officials were overpaying some Medicare health plans by tens of millions of dollars a year, the government dialed back efforts to recover as much of the money as possible, newly released records show.

The privately run Medicare Advantage plans offer seniors an alternative to traditional ...

White House budget director Shaun Donovan called for a "more aggressive strategy" to thwart improper government payments to doctors, hospitals and insurance companies in a previously undisclosed letter to Health and Human Services Secretary Sylvia Mathews Burwell earlier this year.

Government health care programs covering millions of Americans waste billions ...

A whistleblower case in Texas accuses a medical consulting firm and more than two dozen health plans for the elderly of ripping off Medicare by conducting in-home patient exams that allegedly overstated how much the plans should be paid.

The Texas litigation, whose details were unsealed by the court in ...

On the ninth floor of a glassy high rise in downtown Washington, partitions are coming down to make more room for workers handing out billions of dollars in Obamacare-funded research awards.

Business has been brisk at the Patient-Centered Outcomes Research Institute or, PCORI, as it is known. The institute ...

Government audits just released as the result of a lawsuit detail widespread billing errors in private Medicare Advantage health plans going back years, including overpayments of thousands of dollars a year for some patients.

Since 2004, private insurers that run Medicare Advantage plans, an increasingly popular alternative to traditional Medicare, ...

The Supreme Court ruling in favor of the Obama administration means 6.4 million people won't lose subsidies that helped them afford health insurance.

But the historic ruling in King v. Burwell may be far from the last word on health overhaul.

Bills to advance or cripple the law in statehouses ...

Federal officials have spent years locked in a secret legal battle with UnitedHealth Group, the nation's biggest Medicare Advantage insurer, after a government audit detected widespread overbilling at one of the company's health plans, newly released records show.

The audit found that Medicare paid too much for nearly half of ...

Senate Judiciary Committee Chairman Chuck Grassley has asked Attorney General Loretta Lynch to tighten scrutiny of Medicare Advantage health plans suspected of overcharging the government, saying billions of tax dollars are at risk as the popular senior care program grows.

In May 19 letters to Lynch and

On Wall Street, Feb. 3, 2011, was mostly a ho-hum day. But not for companies that sell Medicare Advantage plans.

Several of those that offer the privately run Medicare coverage option hit the jackpot, tacking on billions of dollars in new value after federal officials signaled they might go easy ...

Privately run Medicare plans, fresh off a lobbying victory that reversed proposed budget cuts, face new scrutiny from government investigators and whistleblowers who allege that plans have overcharged the government for years.

Federal court records show at least a half dozen whistleblower lawsuits alleging billing abuses in these Medicare Advantage ...

A heavy workload caused by the Affordable Care Act, government technology limits and staff shortages are causing unusually long delays in filling public records requests, federal health officials say.

The waits in some cases could stretch out a decade or more.

The Freedom of Information Act requires federal ...

Federal health officials were advised in 2009 that a formula used to pay private Medicare plans triggered widespread billing errors and overcharges that have since wasted billions of tax dollars, newly released government records show.

Privately run Medicare Advantage plans offer an alternative to standard Medicare, which pays doctors for ...

As the nation awaits a Supreme Court ruling on Obamacare, lawmakers in many states are moving ahead with a range of Affordable Care Act bills, some of which seek to bolster the law and others that are bent on derailing it.

The Supreme Court case, King v. Burwell, focuses on ...

Humana, Inc. faces new scrutiny from the Justice Department over allegations it has overcharged the government by claiming some elderly patients enrolled in its popular Medicare plans are sicker than they actually are.

The Louisville, Ky.-based insurer disclosed the Justice Department's recent civil "information request" in an annual report ...

As privately run Medicare health plans for seniors scramble to stave off proposed funding cuts, federal prosecutors in Florida are pursuing an unusual criminal fraud case that's likely to raise new concerns that some plans may be overcharging the government.

The criminal case is believed to be among the first ...

Oklahoma state Rep. Mike Ritze is a foot soldier — one of hundreds — in a passionate war over the Affordable Care Act that is reigniting as state legislatures convene across the country.

The Republican lawmaker, a family doctor, has stood behind three anti-Obamacare bills supported by conservative groups in ...

The Health and Human Services Office of Inspector General said it would review Medicare Advantage billing practices with an eye toward curbing overcharges.

A nondescript 40,000-square-foot building in Ashland, Oregon, houses one of the world’s most unusual enterprises: the world’s only forensic crime lab — for animals.

If you’re wondering why animals need a forensics lab, consider this: the world trade in illegal wildlife is a $19 billion business — the fourth largest ...