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Government Watchdogs Attack Medicare Advantage for Denying Care and Overcharging

Kaiser Health News

They also called for the Centers for Medicare & Medicaid Services, or CMS, to revive a foundering audit program that is more than a decade behind in recouping billions in suspected overpayments to the health plans, which are run mostly by private insurance companies.

Medicare 105
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Medicare Advantage RADV Audit Final Rule Challenged in Court

Healthcare Law Blog

Refresher on the RADV Final Rule The Final Rule will implement the following changes: CMS will extrapolate RADV audit findings beginning with payment year (“PY”) 2018, and will not extrapolate RADV audit findings for PYs 2011 through 2017, though it will continue to collect the non-extrapolated overpayments that are identified.