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CMS Issues Long-Awaited Medicare Advantage RADV Final Rule

Healthcare Law Blog

On January 30, 2023 , the Centers for Medicare & Medicaid Services (“CMS”) released the long-delayed final rule on risk adjustment data validation (“RADV”) audits of Medicare Advantage (“MA”) organizations (the “Final Rule”). One thing that is certain, CMS can expect further challenges to its RADV audit methodology. 3d 1, 18 n.19

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CMS Updates IPPS Rates, Wage Index and DSH Uncompensated Care in 2024 Final Rule

Hall Render

On August 1, 2023, the Centers for Medicare & Medicaid Services (“CMS”) issued its Final Hospital Inpatient Prospective Payment System (“IPPS”) and Long-Term Care Hospital (“LTCH”) PPS rule for fiscal year (“FY”) 2024 (“Final Rule”). The Final Rule increases the rate for IPPS payments by 3.3%

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Gearing up for Immunizations

Redox

Perhaps more importantly, Meaningful Use spurred adoption on the provider side, requiring that providers use certified EHRs to receive Medicare and Medicaid funds. Meaningful Use Stage 2 in 2012, and made immunization reporting mandatory unless a state had no registry. It also converged on HL7 2.5.1

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Government Watchdogs Attack Medicare Advantage for Denying Care and Overcharging

Kaiser Health News

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.

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