The Center for Public Integrity’s series unearthing potential fraud and waste under the Medicare Advantage program had little help — and apparently little interest — from the Centers for Medicare & Medicaid Services. The insurance program, which Congress established to help control health care costs for older adults, could leave taxpayers on the hook for more than $36 billion, as AHCJ member Fred Schulte and the rest of the investigative team uncovered.
In this “How I did it” article, Schulte explains how the series follows up on CPI’s 2012 Medicare costs investigation, the extensive lengths taken to try to obtain CMS records, work-arounds and other sources the team used to piece together a puzzle that paints a clear picture of improper billing, missed opportunities by regulators, lack of oversight, and industry influence.
