Medicare Advantage Fraud: The Billion-Dollar Upcoding Problem

In this episode of Healthcare Americana, host Christopher Habig sits down with Dr. Marion Mass, pediatrician and co-founder of Practicing Physicians of America, to uncover widespread fraud and abuse in the Medicare Advantage program. They break down how insurers use practices like upcoding, assigning patients exaggerated or false diagnoses, to collect billions in taxpayer dollars each year, with UnitedHealthcare highlighted as a major offender. Dr. Mass explains the systemic conflicts of interest, lack of accountability, and the urgent need for audits, penalties, and transparency to protect both patients and federal budgets. The conversation also highlights the importance of informed healthcare choices and explores how direct care models offer a more sustainable alternative. This episode is a must-listen for anyone concerned about Medicare, insurance oversight, and the integrity of America’s healthcare system.

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