We stand firmly behind the integrity of our Medicare Advantage business and the positive impact it delivers to millions of seniors across the country. As an important public sector partner serving people’s health needs, we expect and welcome regular reviews of our policies and practices. Our operations are governed by strict federal regulations and subject to rigorous oversight, driving transparency and compliance with CMS requirements.
Today’s article from The Wall Street Journal represents a continuation of its sustained campaign against Medicare Advantage, relying on incomplete data, a predetermined narrative and a flawed understanding of how the Medicare Advantage program works.
Independent CMS audits confirm we are among the most accurate in the industry in our coding practices, demonstrating our commitment to integrity and compliance. Additionally, after more than a decade of a similar Department of Justice challenge to our Medicare Advantage business, the Special Master concluded there was no evidence to support the claims that we were overpaid or engaged in any wrongdoing.
We take seriously our role in protecting the integrity of the Medicare Advantage program. We have long advocated for audits across all Medicare Advantage plans each year to give all stakeholders confidence in plan reimbursements and to dispel false narratives about overpayments. We maintain robust procedures and employ certified clinical professionals to ensure our programs meet the highest standards. Recently, we announced that we will deploy a regular, independent third-party coding oversight and audit process to supplement our existing quality assurance program—so all stakeholders can have the same confidence in our performance and compliance that we do.
Ultimately, we remain focused on what matters most: delivering better outcomes, more benefits, and lower costs for the people we serve.
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