Medicare officials are pushing back against a federal watchdog’s call to crack down on home visits by Medicare Advantage health plans — a practice the watchdog says may waste billions of tax dollars every year. In late October, a U.S. Health and Human Services inspector general audit found that the insurers pocketed $7.5 billion in 2023 from diagnosing health conditions that prompted no medical services — about $4.2 billion of it through the health assessments done in patients’ homes. Assistant Inspector General Erin Bliss said that the plans are raking in billions of dollars without providing any treatment for medical conditions the plans flagged during the visits, including serious diseases such as diabetes and major depression. But the power to curb billing tied to home visits rests with regulators at the Centers for Medicare and Medicaid Services, who appear unmoved by the Office of Inspector General’s criticism.

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P.S. This article was published November 27, 2024. Whether the Director of the Centers for Medicare and Medicaid Services for the new administration will pursue the protections remains to be seen.