Fierce Healthcare March 18, 2022
The Department of Health and Human Services (HHS) is examining risk adjustment tactics that have led to overpayments to some Medicare Advantage plans, Secretary Xavier Becerra told reporters Friday.
Becerra said the agency has seen evidence of charges going beyond what would be necessary for MA plans using tactics such as up-coding. The remarks come as some progressive lawmakers have clamored for more scrutiny of the popular program that enables seniors to use their Medicare benefit to buy a private plan.
“So far from what I understand in the evidence and data, it shows that we spend more per Medicare recipient through MA than through fee-for-service,” Becerra said. “We have seen some evidence that in certain areas...