2024 Medicaid Overpayment 
Hall Render
DECEMBER 27, 2023
Under the federal Stark Law, hospitals, physician groups, labs and other provider entities may provide non-monetary ( i.e. , non-cash or cash equivalent) compensation to physicians up to an aggregate amount of $507 for calendar year 2024.
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 ). We note that the greatest increase in enrollment in MA for 2024 was in dual-eligible special need plans.
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Health Care Law Brief
APRIL 12, 2023
On April 5, the Centers for Medicare & Medicaid Services (“CMS”) released the 2024 Medicare Advantage and Prescription Drug Benefit Programs Final Rule (“Final Rule”), which will be codified at 42 C.F.R. The SRFs include low-income subsidy, dual eligibility (meaning eligible for Medicare and Medicaid) and disability.
Health Care Law Brief
MAY 11, 2022
The vesting periods shall be up to two (per covered employer) six-month periods between October 1, 2021 and March 31, 2024 for which workers that are continuously employed by an employer during such six-month periods may become eligible for a bonus. Covered Employers. Covered Employer Tracking and Recordkeeping.
AIHC
SEPTEMBER 30, 2024
This was originally mandated by the Centers for Medicare & Medicaid Services (CMS) back in 1997 and implemented in 2004. Recent OIG reports of risk adjustment audits published in September 2024 indicate noncompliance with Federal requirements. HCC coding relies on ICD-10-CM coding to assign risk scores to patients.
HIT Consultant
SEPTEMBER 27, 2024
Increasingly rigorous oversight from the Centers for Medicare & Medicaid Services (CMS) and Office of the Inspector General (OIG) are calling for better diligence, planning and administrative oversight for effective risk adjustment. billion in overpayments to MA plans with this new audit methodology over the next ten years.
HIT Consultant
MARCH 20, 2024
The Centers for Medicare and Medicaid Services (CMS) estimated that for payment year 2018 alone , it will recover $428.4 To address these concerns and other matters, CMS announced significant regulatory changes to the Medicare Advantage (MA) program beginning in 2024. million (net) and $4.7
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