Remove 2012 Remove Doctors Remove Medicaid Remove Overpayments
article thumbnail

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. CMS is scheduled to release the audits later this year.

Medicare 105
article thumbnail

Medicare Advantage RADV Audit Final Rule Challenged in Court

Healthcare Law Blog

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. CMS previously addressed this problem and provided for a solution in its February 2012 announcement of the FFS Adjuster.