Medicare’s midterm punts, MA marketing schemes, and a closer look at the Abiomed deal

STAT November 7, 2022
Bob Herman

Medicare punts big moves ahead of midterms

Medicare unleashed an avalanche of payment regulations and rules in the past week, and there was a subtle theme hanging over everything: Don’t rock the boat too much for the industry or for seniors, a crucial voting bloc in this week’s midterm elections.

Most notably, CMS punted, yet again, on whether to make Medicare Advantage audits more aggressive. A decision now won’t be made until February. Medicare Advantage insurers despise the thought of the government clawing back more money through these audits, known as “risk adjustment data validation” or RADV. This regulation has been in the works for four years, but CMS said “additional time continues to be needed to address the complex...

Today's Sponsors

Today's Sponsor