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CMS’s Final Rule on Medicare Advantage Risk Adjustment Data Validation

Health Law Advisor

For these years, CMS will limit payment recoveries to “enrollee-level adjustments,” i.e., the non-extrapolated overpayments identified in CMS RADV audits and Department of Health and Human Services Office of Inspector General (OIG) audits. million per year starting in 2025 for PY 2018 from extrapolated recoveries.

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Health Provider News

Hall Render

to Study Treatments for Vascular Abnormalities Federal Appeals Court Hears Arguments on Nation’s First Ban on Gender-affirming Care for Minors Jason Demke Hired as COO at Mercy Hospital Fort Smit Pulaski Tech Awarded $5.7M Can lawmakers do anything about it?

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Health Provider News

Hall Render

Million CALIFORNIA California hospital dismisses CEO California physician pleads guilty to $2.5M million expansion ‘Very, very unusual.’ Health Policy Commission still missing key document in Steward sale to Optum Local obesity drug developer lands deal worth up to $600M with Novo Nordisk Mass. Dallas Home Health Company to Pay $4.7

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Health Provider News

Hall Render

NATIONAL 382 rural hospitals cut chemotherapy, breakdown by state 1 year after Amazon-One Medical deal finalized: What’s happened since ACOs want increased participation of long-term and post-acute care providers ‘Behind the times’: DC tries to catch up with AI’s use in health care CMS finalizes DSH payment cuts for some safety-net hospitals: (..)

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Health Provider News

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lays off 1,000 workers New York ASC sued following July data breach New York governor reaches deal to keep SUNY Downstate open See who tops the 2024 Independent Living Communities List New York health system names network VP of revenue cycle SUNY Downstate gets $300M in New York 2025 budget Changing demographics in nursing homes across N.Y.

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CMS Issues CY2024 Proposed Rule for Medicare Advantage Organizations and Part D Sponsors

Healthcare Law Blog

The Proposed Rule includes changes on an array of topics including: Star Ratings, medication therapy management, marketing and communications, health equity, provider directories, coverage criteria, prior authorization, behavioral health services, identification of overpayments , requirements for valid contract applications, and formulary changes.

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Health Provider News

Hall Render

assisted technology for colonoscopies Sanford Health found non-compliant in nine areas according to ND agency Sanford Ambulance reports high call volume, worries about workforce retention OHIO Christ Hospital Foundation taps a new president following Rick Kammerer’s retirement Cincinnati Children’s awarded $2.6