In this episode of The Journal, Jessica Mendoza and Wall Street Journal reporters Ana Wildey-Matthews and Chris Weaver discuss their investigation into Medicare Advantage, a government-funded healthcare program managed by private insurance companies. The investigation revealed that insurers are allegedly gaming the system by adding diagnoses to patient records to increase government payments, sometimes for conditions that patients don't have or aren't being treated for, such as diabetic cataracts, peripheral artery disease, and even HIV. Kristen Bell, a nurse practitioner who worked for UnitedHealth, shares her experience of being encouraged to add diagnoses and conduct unnecessary tests, contributing to billions of dollars in extra payments to insurers. The report raises concerns about the misuse of taxpayer money and the potential for compromised patient care within the Medicare Advantage system.
