The Centers for Medicare and Medicaid Services (CMS) has issued a final rule that will increase the amount federal authorities can recoup from Medicare Advantage organizations (MAOs) that were overpaid due to incorrect diagnostic coding.
The Medicare Risk Adjustment Data Validation (RADV) final rule means that CMS will also stop...
Last week, the Centers for Medicare and Medicaid Services (CMS) released a Request for Information (RFI), seeking comment on ways to improve Medicare Advantage and make the program more equitable, affordable and sustainable.
Medicare Advantage (MA) has been under great scrutiny lately, for policies on prior authorization, the adequacy...
A bipartisan group of senators, including Senators Kyrsten Sinema (D-AZ) and Mark Kelly (D-AZ), sent a letter to the Centers for Medicare and Medicaid Services (CMS) Administrator Chiquita Brooks-LaSure last Friday, warning against any potential cuts to the Medicare Advantage (MA) program. The letter comes as Democrats look for places to...
A report from the Department of Health and Human Services (HHS) inspector general's office analyzed Medicare Advantage (MA) encounter data from 2016, stemming from concerns that MA organizations use chart reviews to inaccurately inflate risk adjusted payments. The result was billions in additional payments.
The Office of Inspector...
