Healthcare DIVE November 17, 2022
Rebecca Pifer

Regulators have considered changing how they calculate patient risk and reimbursement levels for providers, work that the HHS head said is continuing.

Despite criticisms over inaction, the HHS is aware of the flurry of fraud in the Medicare Advantage program that’s costing the government billions of dollars a year, and is thinking about how to curb it, department officials said at HLTH this week.

The HHS is currently reviewing public comments on how to improve MA, including strategies for paring back on fraud and abuse, and plans to make policies based on the evidence, HHS Secretary Xavier Becerra said Tuesday. That could include changing the risk adjustment formulas.

“There are some who say there’s been a racket going on where...

Today's Sponsors

LEK
ZeOmega

Today's Sponsor

LEK

 
Topics: Conferences / Podcast, Govt Agencies, HHS, Insurance, Medicare Advantage, Patient / Consumer, Payer, Provider, Trends
CMS proposes new guardrails on Medicare Advantage prior authorizations, marketing
CMS' proposed changes to Medicare Advantage: 10 things to know
Medicare Advantage Plans' Prior Auth Rules Would Be Made Public Under CMS Proposal
CMS pitches major Medicare Advantage changes: 10 notes
[Updated] CMS Issues ‘Guardrails’ to Improve Medicare Advantage Access and Transparency

Share This Article