HHS OIG Flags $2.2 Billion in Potential Medicare Advantage Overpayments for CMS Audits
CMS said it plans to audit risk-adjustment payments that Medicare Advantage (MA) plans received based on having identified additional diagnoses in beneficiary medical chart reviews. CMS’s action was spurred by a recent report from the HHS Office of Inspector General (OIG) entitled, “Billions in Estimated Medicare Advantage Payments From Chart Reviews Raise Concerns.” (Click here for the report).
As the OIG’s report explains, MA insurers receive risk-adjustment payments, based in part on diagnoses, to account…