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...

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