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CMS Publishes RADV Audit Methodology and Intent to Recover Overpayments

Hall Render

FEBRUARY 14, 2023

billion in overpayments from MAOs for payment years 2011 through 2017. billion in overpayments from MAOs for payment years 2011 through 2017. Further, CMS estimates that beginning with payment year 2018, it will identify approximately $479 million per audit year in overpayments to MAOs.

Overpayments

Overpayments Overpayment Medicare Medicare

Medicare Advantage RADV Audit Final Rule Challenged in Court

Healthcare Law Blog

SEPTEMBER 28, 2023

The Centers for Medicare & Medicaid Services (“CMS”) released the final rule on risk adjustment data validation (“RADV”) audits of Medicare Advantage (“MA”) organizations (the “Final Rule”) on January 30, 2023. This bargain is codified in the statutory mandate of 42 U.S.C. 1395w-23(a)(1)(C)(i) “to ensure actuarial equivalence.”

Medicare

Medicare Medicare Overpayments Overpayment

CMS Publishes RADV Audit Methodology and Intent to Recover Overpayments

Medicare Advantage RADV Audit Final Rule Challenged in Court

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