Bad news! If confirmed, then this is a huge scandal!
"Some private Medicare Advantage insurers pushed nurses to run screening tests and add unusual diagnoses that entitle the companies to extra money, a WSJ investigation found. The roughly hourlong stops turned into $1,818 more per visit, on average, from 2019 to 2021—about $15 billion in total. Many insurer-driven diagnoses were wrong or highly questionable. Private insurers denied using inaccurate diagnoses to jack up their payments. The Medicare Payment Advisory Commission, a nonpartisan agency that advises Congress, recommended not using home-visit diagnoses toward extra payments, and the overseeing inspector general advised reconsidering using these diagnoses. The Centers for Medicare and Medicaid Services said the agency recently increased its diagnosis audits and is making some diagnoses ineligible for extra payments."
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