Government watchdogs are calling on CMS to recoup the overpayments. Hospitals upcoded severe malnutrition diagnosis codes on inpatient hospital claims in 2016 and 2017, reaping an estimated $1 billion ...
Incorrect diagnosis codes from providers led to a $14 million windfall for some Medicare Advantage plans, a federal watchdog found. The Department of Health and Human Services’ Office of Inspector ...
Some limits on how the assessments are used for adding new diagnosis codes might be justified to ensure Medicare Advantage plans aren’t overpaid, researchers wrote. Under MA, insurers contract with ...
A Medicare Advantage plan run by CVS inflated diagnoses for its members between 2018 and 2019, resulting in almost $7 million in estimated overpayments, according to a new audit by the HHS Office of ...
In the complicated world of hospital billing, there’s a fine line between maximizing reimbursement and gaming the system. A new study shows a troubling trend as hospitals increasingly code for “sicker ...
As we reported in our Managed Care Newsletter in April 2020, the CARES Act passed by Congress last year provides for a 20% increase to the DRG weights in the Medicare Inpatient Prospective Payment ...
Results that may be inaccessible to you are currently showing.
Hide inaccessible results