News Briefs
October 21
✦ CMS has given itself another year to finalize a proposal to begin using an extrapolation methodology in recovering overpayments from Medicare Advantage organizations. The Trump administration in a November 2018 proposed rule (83 Fed. Reg. 54982, Nov. 1, 2018) said it planned to extrapolate the results of Risk Adjustment Data Validation Audits, starting with 2011 contract-level audits, and not apply a “fee-for-service adjuster” to account for inaccurate diagnosis codes in FFS Medicare data used to calibrate the MA risk adjustment model.
© 2023 MMIT
Related Posts
February 2
Medicaid Beneficiaries Are Unequally Served by Non-Emergency Medical Transportation
READ MORE
February 2
With Final RADV Rule Out, MAOs Are Advised to Clean Up Risk Adjustment Practices
READ MORE
February 2
As Medicaid Redeterminations Loom, MCOs Can Help States Ease the Process
READ MORE
Meet Our Reporters
-
Angela Maas Managing Editor, RADAR on Specialty Pharmacy and Spotlight on Market Access
View Angela Maas's Profile -
Leslie Small Managing Editor, Health Plan Weekly and RADAR on Drug Benefits
View Leslie Small's Profile -
Lauren Flynn Kelly Managing Editor, RADAR on Medicare Advantage
View Lauren Flynn Kelly's Profile -
Peter Johnson Reporter, Health Plan Weekly and RADAR on Drug Benefits
View Peter Johnson's Profile -
Tim Casey Reporter, Health Plan Weekly and RADAR on Drug Benefits
View Tim Casey's Profile -
Carina Belles Reporter, RADAR on Medicare Advantage and Spotlight on Market Access
View Carina Belles's Profile -
Jinghong Chen Reporter, Health Plan Weekly and RADAR on Drug Benefits
View Jinghong Chen's Profile -
Jill Brown Kettler Executive Editor
View Jill Brown Kettler's Profile
