How can we inform Medicare about their fraud. All they care about is about filling out surveys and filling them again and again... what for? No time to offer Member any services! Members continue receiving repeated calls with same questions!!!!! Who is benefiting here????
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for Medicare: 800-633-4227, main number and call to tell them you want to report fraud
Humana doesn't get money each time the HRA is done. Medicare requires sequencing once a year, with a plan change, or change in status. It doesn't need to be done "over and over" again, not sure why people are even wasting their time doing it. Humana gets paid for Medicare Advantage members who are managed on month to month basis. Completing the surveys no matter how many times they are completed is not fraud. If you are taking about an mdat risk score, since this assessment shows a picture of the member at that specific time and day the call is made, there can be changes in the score. Changes can occur with how its conducted, every one does this differently. These members are really sick and their status can change also, accounting for the differences in scores.
https://www.publicintegrity.org/2016/03/04/19397/yet-another-whistleblower-alleges-medicare-advantage-fraud
It seems the lesson was not learned!!!
If Humana wasn't committing fraud with their risk score increases without justification, they wouldn't have received a 3.1 million dollar fine three for fraud identified from a 2015 audit. Something is amiss.
Over and over again is not fraud?
I don't think there is any fraud here. Medicare requires these surveys and we are doing them. A simple audit will show that "fraud" is not founded