CMS to speed up, beef up Medicare Advantage audits

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3 Min Read

Bob Herman , 2025-05-21 21:41:00

Bob Herman covers health insurance, government programs, hospitals, physicians, and other providers — reporting on how money influences those businesses and shapes what we all pay for care. He is also the author of the Health Care Inc. newsletter. You can reach Bob on Signal at bobjherman.09.

President Trump’s federal Medicare agency will expedite audits of Medicare Advantage insurers, a move that could claw back nearly $500 million a year for taxpayers, according to previous federal estimates.

However, the audits remain mired in a two-year-old lawsuit initiated by Humana, making it unclear how the Trump administration will implement its new strategy.

The Centers for Medicare and Medicaid Services said Wednesday it will hire almost 2,000 additional coders by this September and use “advanced” technology systems to comb through data and make sure diagnoses that Medicare Advantage insurers submit to the government are supported in patients’ medical records. The agency did not say what kind of technology it would use.

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