OIG recommends greater oversight of MA risk-adjusted payments
Medicare Advantage organizations received $6.7 billion in risk adjustment payments in 2017 for diagnoses that were not supported by the medical record, according to a report released this week by the Department of Health and Human Services’ Office of Inspector General. While the plans may have failed to submit all service records as required, OIG said the finding raises concerns about program integrity and recommended the Centers for Medicare & Medicaid Services take steps to improve its oversight of MA plans.
Related News Articles
Headline
The Centers for Medicare & Medicaid Services Sept. 18 released a final rule on policy and technical changes to Medicare Advantage, the Medicare…
Headline
The AHA Sept. 15 expressed support for the Ensuring Access to Essential Providers Act, legislation that would require Medicare Advantage plans to cover…
Headline
The AHA Sept. 15 urged Aetna to rescind its recently announced “level of severity inpatient payment” policy, saying that it “could erode the transparency…
Headline
A JAMA internal medicine study published Sept. 8 found that since the COVID-19 pandemic, Medicare Advantage beneficiaries have been experiencing longer…
Headline
A Health Affairs study published Sept. 2 found that less than 40% of Medicare beneficiaries with opioid use disorder received standard care in alignment with…
Headline
The Department of Health and Human Services and the Centers for Medicare & Medicaid Services Aug. 21 announced the creation of a Healthcare Advisory…