According to an article in the March 19, 2008 issue of the Wall Street Journal, government regulators are increasing their scrutiny of Medicare and Medicaid managed-care providers.
The managed-care industry covers more than 37 million state and federal beneficiaries. They typically receive fixed payments per patient, regardless of how many services are provided. Some of the ways they have attempted to illegally increase their profits include shortchanging patients or physicians to cut costs while collecting preset fees from the government. They might refuse to enroll unhealthy people, skimp on paying doctors or deny patients care.