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.