Health Law Advisor

FEBRUARY 2, 2023

On February 1, 2023, the Centers for Medicare & Medicaid Services (CMS) published a final rule outlining its audit methodology and related policies for its Medicare Advantage (MA) Risk Adjustment Data Validation (RADV) program. The final rule codifies long-awaited regulations first proposed by CMS in 2018.

Medicare 98

Medicare Medicare Overpayments Overpayment 98

Health Law RX

NOVEMBER 9, 2021

For the first time since 2013, on November 8, 2021, the Department of Health and Human Services Office of Inspector General (“OIG”) updated its Health Care Fraud Self-Disclosure Protocol (“SDP”). The likelihood that a self-discloser would be required to pay a damages multiplier greater than 1.5

Fraud 52

Fraud Overpayments Overpayment Governance 52

HIPAA Journal

MARCH 30, 2022

Furthermore, it could also be argued that neither Rule was effectively enforced until the Omnibus Final Rule was published in 2013. billion recovered relating to Medicare fraud alone. It was not until 2002 that the Privacy Rule was published, and 2003 that the Security Rule was published. How HIPAA Addressed Health Insurance Reform.

HIPAA 119

HIPAA Fraud Health Insurance Health Care Reform 119

Kaiser Health News

JUNE 29, 2022

Congress should crack down on Medicare Advantage health plans for seniors that sometimes deny patients vital medical care while overcharging the government billions of dollars every year, government watchdogs told a House panel Tuesday. Medicare Advantage plans accept a set fee from the government for covering a person’s health care.

Medicare 105

Medicare Medicare Governance Overpayments 105