6 Medicare Advantage plans audited for upcoding in the last six months

Audits published in the last six months found almost $32 million in overpayments across six Medicare Advantage plans, according to HHS’ Office of Inspector General’s semiannual report to Congress. 

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By: Rylee Wilson

The report, published June 2, summarizes audits the office published between October 2022 and March 2023. 

Here are the Medicare Advantage plans the agency audited during that time: 

  1. Blue Cross and Blue Shield of Rhode Island received an estimated $4.8 million in overpayments between 2016 and 2017. 
  2. California Physicians Services, a Blue Shield of California plan, received an estimated $2 million in overpayments in 2016 and 2017. 
  3. Cigna HealthSpring of Tennessee received an estimated $5.9 million in overpayments in 2016 and 2017. 
  4. Geisinger Health Plan received an estimated $6.8 million in overpayments in 2016 and 2017. 
  5. MCS Advantage, a Puerto Rico-based plan, received an estimated $6.2 million in overpayments in 2016 and 2017.
  6. CignaHealthSpring Life & Health Insurance Company received an estimated $6.24 million in overpayments in 2016 and 2017.  
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