A recently released analysis estimates federal (MA) overpayments between 2010 and 2019 resulted from private plans' "inventing new ways to increase their enrollees' risk scores," just as sales of Medicare Advantage (MA) plans skyrocket and SCAN launches "Welcome Health" an independent primary care medical group that will deliver...
The Office of Inspector General (OIG) for the U.S. Department of Health and Human Services (HHS) ran an audit on Aetna's Medicare Advantage (MA) business according to parent company CVS Health. The HHS OIG has cracked down on inaccurate adjustment scores submitted by MA plans including Humana and Anthem.
Aetna's MA reimbursement is...National News
The agency released Part 1 of the 2020 Advance Notice on Dec. 19; The Centers for Medicare & Medicaid Services (CMS) is proposing to include additional patient conditions when calculating risk adjustment payments for Medicare Advantage (MA) plans.
CMS also proposes to adjust its risk score calculation by boosting the weight of...
