Overpayment Rule News Today

Cigna recently agreed to pay $172 million to resolve allegations that it violated the False Claims Act. One expert said this is just a small part of the problem, while another called for more clarity from the government.

Centers for Medicare and Medicaid Services released the final rule on risk adjustment data validation audits of Medicare Advantage organizations. There are three key components of the Final Rule and requires MAOs to remit improper payments identified during RADV audits.

The Centers for Medicare and Medicaid Services (CMS) issued a final rule on the use of extrapolation to determine overpayments in risk adjustment data validation (RADV) audits of...

Medicare Advantage (Medicare Part C) remained a top enforcement priority in 2022, and Medicare Advantage Organizations (MAOs) are the subject of intense scrutiny by the Department of Justice...

Medicare Advantage (Medicare Part C) remained a top enforcement priority in 2022, and Medicare Advantage Organizations (MAOs) are the subject of intense scrutiny by the Department of...

Medicare Advantage Medicare Part C remained a top enforcement priority in 2022, and Medicare Advantage Organizations MAOs are subject of intense scrutiny by the Department of Justice DOJ; the Office of Inspector General for the Department of Health and Human Services.

On February 1, the Centers for Medicare & Medicaid Services (CMS) published the Medicare Advantage (MA) Risk Adjustment Data Validation (RADV) Program Final Rule (Final Rule), which...

On January 30, 2023, the Centers for Medicare & Medicaid Services released the long-delayed final rule on risk adjustment data validation audits of Medicare Advantage organizations

The Centers for Medicare & Medicaid Services CMS released the long-delayed final rule on risk adjustment data validation RADV audits of Medicare Advantage MA organizations. CMS promotes the Final Rule as improving program integrity and payment accuracy.

On January 30, 2023, the Centers for Medicare & Medicaid Services (“CMS”) released the long-delayed final rule on risk adjustment data validation (“RADV”) audits of Medicare Advantage...