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. billion between 2023 and 2032 from MAOs based on both non-extrapolated and extrapolated overpayment amounts.

Medicare 98

Medicare Medicare Overpayments Overpayment 98

The Health Law Firm

JULY 6, 2015

FACTS: Via three Final Audit Reports dated July 10, 2013, AHCA advised the Chrysalis Center that it had overbilled the Medicaid program by $284,535.83 Indest III, J.D., for community mental health services.

Medicaid 40

Medicaid Medicaid Overpayments Overpayment 40

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. 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. These are THE 3 Major Things Addressed in the HIPAA Law.

HIPAA 125

HIPAA Fraud Health Insurance Health Care Reform 125

Kaiser Health News

JUNE 29, 2022

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

Medicare Medicare Governance Overpayments 105