it could be a valuable part of the solution to MA’s multibillion-dollar overpayment problem. The 2023 final rule on Medicare Advantage RADV audits is a glass both half empty and half full.

Nursing home stakeholders remain cautiously optimistic regarding Medicare Advantage plan audits announced by the Centers for ...

The Centers for Medicare & Medicaid Services (CMS) recently announced it was expanding its efforts to audit Medicare ...

Medicare Advantage has become a system dominated by a handful of massive insurers who are gaming the rules for profit and ...

Medicare Advantage plans are based on an enrollee's diagnosis; those with more serious or chronic conditions receive higher ...

The CMS will crack down on overpayments to Medicare Advantage plans, moving to significantly expand its capacity to audit whether insurers are inflating their enrollees’ illnesses, the agency ...

“While the Administration values the work that Medicare Advantage plans ... Previously completed audits of payment years 2011 to 2013 revealed overpayment rates of between 5% and 8%.

The government's audits uncovered about $12 million in net overpayments for the care of 18,090 patients sampled, though the actual losses to taxpayers are likely much higher. Medicare Advantage ...

The suit asks for correspondence and other records of contact between HHS officials or their representatives and Medicare Advantage organizations concerning overpayment audit findings and ...