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

Health Law Advisor

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. The final rule codifies long-awaited regulations first proposed by CMS in 2018. This total includes $41.1

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Medicare Audit Claims University of Miami Hospital Owes Government $3.7 Million

The Health Law Firm

Board Certified by The Florida Bar in Health Law The University of Miami Hospital allegedly owes Medicare $3.7 The report was released on October 8, 2013, by the US Department of Health and Human Services (HHS) Office of Inspector General (OIG). Indest III, J.D.,

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Hot off the Press! The OIG Revises its Self-Disclosure Protocol for the First Time in Several Years

Health Law RX

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

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What Are THE 3 Major Things Addressed in the HIPAA Law?

HIPAA Journal

Furthermore, it could also be argued that neither Rule was effectively enforced until the Omnibus Final Rule was published in 2013. billion recovered relating to Medicare fraud alone. 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.

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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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