As the Biden administration promised, the U.S. Department of Health Services (HHS) Office of Inspector General (OIG) is sifting through claims submitted by Medicare Advantage (MA) plans, looking for fraudulent activity.
The OIG published two audits this week on Medicare Advantage Compliance of diagnostic codes submitted to the Centers...Arizona News
MA insurers are auditing patient's medical charts to find more diagnosis codes in effort to get larger reimbursements from the Medicare program. The business of insurance encourages the documentation of all possible diagnoses to generate billions in profits. Modern Healthcare cites an Anthem lawsuit as an example of the returns...