CMS to expand audits of MA plans
The Centers for Medicare & Medicaid Services May 21 announced it will immediately begin annual audits of all Medicare Advantage plans and work to clear a backlog of audits from 2018 through 2024. The audits focus on risk adjustment data validation to confirm to CMS that diagnoses submitted by Medicare Advantage plans for determining risk adjustment payments are supported by medical records. CMS expects to complete the backlog by early 2026. The agency said it will use new technology and increase its team of medical coders from 40 to approximately 2,000 to assist with efforts.
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