Fierce Healthcare

OCTOBER 6, 2023

million in overpayments from Medicare Advantage in 2015 and 2016. | million in overpayments from Medicare Advantage in 2015 and 2016. A new federal audit estimates that Aetna may have received at least $25.5 A new federal audit estimates that Aetna may have received at least $25.5

Overpayments 95

Overpayments Overpayment Medicare Medicare 95

Healthcare Law Today

JANUARY 2, 2023

As written, the proposed rule would remove the existing “reasonable diligence” standard for identification of overpayments, and add the “knowing” and “knowingly” FCA definition. And, a provider is required to refund overpayments it is obliged to refund within 60 days of such identified overpayment.

Overpayments 52

Overpayments Overpayment ACA Medicare 52

Health Law Advisor

FEBRUARY 2, 2023

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. million from non-extrapolated errors based for PYs 2011–2015, an estimated average of $8.2

Medicare 98

Medicare Medicare Overpayments Overpayment 98

Health Care Law Brief

APRIL 3, 2023

On Friday, March 31, 2023, the Centers for Medicare & Medicaid Services (CMS) released the Calendar Year (CY) 2024 Medicare Advantage (MA) Capitation Rates and Part C and Part D Payment Policies ( Rate Announcement ). 1395w-23): Medicare Advantage Organizations (MAOs) are paid a base rate by CMS. Risk Adjustment.

Medicare 52

Medicare Medicare Overpayments Overpayment 52

The Health Law Firm

NOVEMBER 21, 2014

This Work Plan is the general overview of how the OIG intends to carry out its mission to make the Medicare and Medicaid programs run more smoothly and efficiently in the following year. A large part of what the OIG does is review and investigate Medicare claims for overpayment.

Overpayments 40

Overpayments Overpayment Medicare Medicare 40

CMS.gov

NOVEMBER 16, 2018

2018 Medicare Fee-For-Service improper payment rate is lowest since 2010. Administrator, Centers for Medicare & Medicaid Services. 2018 Medicare Fee-For-Service improper payment rate is lowest since 2010 Significant progress in saving $4.59B in estimated improper payments for the Medicare Fee-For-Service program.

Medicare 20

Medicare Medicare Overpayments Overpayment 20

Hall Render

JUNE 22, 2022

On Friday, June 17, 2022, the Centers for Medicare & Medicaid Services (“CMS”) posted a pre-publication copy of the Calendar Year (“CY”) 2023 Home Health Prospective Payment System Rate Update (“PPS Rule”). CMS states a temporary adjustment is necessary to offset this overpayment. Submission of All-Payer OASIS Data.

COVID-19 40

COVID-19 Payment Systems Medicare Medicare 40