Major Medicare plans are often inflating how sick their members are — and in at least one example, went so far as to add diagnoses doctors hadn't made — to bilk millions of dollars from the health care system, a whistleblower told Bloomberg.

• In one case, a woman was even coded for prostate cancer, according to the report.

Why it matters: Medicare Advantage is fast growing in popularity — and in the amount of money it's costing the health care system as seniors flock to the plans.

Between the lines: Insurers say Medicare Advantage delivers better services, better access to care and better value than traditional Medicare.

• But as Adriel recently reported, health insurers that sell private Medicare plans collected $12 billion more caring for seniors in 2020 than it would have cost in traditional Medicare.
• A report from the Medicare Payment Advisory Commission attributed the difference to aggressive medical record coding.

Yes but: Private insurers who administer Medicare Advantage plans just got a bigger than expected pay bump from the Biden administration.

What's next: One of the nation's leading MA plans, Kaiser Permanente, is facing its own risk adjustment scandal.

• The Department of Justice called addressing Medicare fraud an important priority, Bloomberg reported.

Roughly one in four Black and Latino adults ages 60 and older say health care professionals treated them unfairly or ignored their health concerns because of race or ethnicity, according to a survey out today...

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