The OIG has issued their Semiannual Report to Congress for the period April 1, 2023 through September 30, 2023. The report highlights $3.44 billio...
Overpayments Related to Improper HCCs Continue to Increase
The government is increasing enforcement efforts around proper risk adjustment coding (HCC coding). We continue to see regular audit reports det...
OIG Work Plan Update Aimed at Medicare Advantage Risk Adjustment Coding
Today, the OIG issued their July Work Plan. The update is heavily focused on risk adjustment coding (Hierarchical Condition Category (HCC) Codin...
OIG Semiannual Report to Congress
The OIG has issued their Semiannual Report to Congress for the period October 1, 2022 through March 31, 2023. The report highlights over $1 billion...
Improper Billing of Mid-Level Practitioner Services
Last week, the Department of Justice (DOJ) announced a $516,718 false claims settlement related to improper billing of mid-level practitioner services...
CMS Medicare Advantage Final Rule Takes Aim at Risk Adjustment Coding
Yesterday, CMS released the Medicare Advantage (MA) Risk Adjustment Data Validation Final Rule. The Final Rule is intended to strengthen the acc...
2022 Medicare Improper Payments Data
2022 Medicare Fee-For-Service Improper Payments Report was just released. The report identified an estimated $31.46 billion in improper payments...
OIG Fall 2022 Semiannual Report
The OIG has issued their Semiannual Report to Congress for the period April 1, 2022 through September 30, 2022. The report highlights over $4 billi...
New OIG Audit Findings
The OIG has released two new reports detailing high payment error rates for Advanced Care Planning and Assistant at Surgery and Co-Surgeon Services. A...