Breaking Down Medicare Advantage Fraud with Eva Gunasekera
From Fraud in America by The Anti-Fraud Coalition, TAF Coalition
November 12, 2025 · 60 min · Episode 62
About this episode
This episode discusses the rise of fraud in Medicare Advantage and its implications for taxpayer money.
Medicare Advantage has grown to insure over half of all Medicare beneficiaries, but with that explosive growth has come an explosion in fraud. Billions of dollars in taxpayer money are being siphoned off through schemes that exploit the program's risk-adjustment payment system—from upcoding patient diagnoses to fabricating medical conditions entirely.
People in this episode
Guest: Eva Gunasekera
Topics covered
- Medicare Advantage
- healthcare fraud
- risk-adjustment payment system
- upcoding
- taxpayer money
- medical conditions
Keywords
- Medicare Advantage
- fraud
- upcoding
- risk-adjustment
- taxpayer money
- healthcare schemes
Mentioned in this episode
Organizations: Medicare Advantage, Anti-Fraud Coalition, TAF Coalition
More episodes of Fraud in America
- Blow that Whistle Loud! Anti-SLAPP and Other Protections for Whistleblowers · April 1, 2026 · 53 min
- Financial Fraud Year In Review · March 13, 2026 · 53 min
- A Conversation with Gardiner Harris · February 4, 2026 · 1h 2m
- AI and SEC Enforcement Priorities · December 3, 2025 · 20 min
- AI Regulation and Whistleblowing · November 26, 2025 · 31 min
- AI Overview · November 20, 2025 · 49 min
Explore listener stats, chart rankings, contacts and more on the Fraud in America podcast page.