HealthLeaders Media February 1, 2023
The federal agency will likely claim back billions of dollars in overpayments from health insurers that operate Medicare Advantage plans.
KEY TAKEAWAYS
– CMS released its Medicare Advantage Risk Adjustment Data Validation final rule to collect overpayments from health plans beginning from 2018.
– Payer groups like AHIP, Better Medicare Alliance, and Blue Cross Blue Shield Association have reacted to the rule with displeasure, arguing that the rule will have the downstream effect of hurting seniors’ care.
Payer organizations have expressed their disappointment for the Medicare Advantage Risk Adjustment Data Validation (RADV) final rule released by CMS, claiming the auditing standards will have the “potential unintended consequence” of harming beneficiaries.
The rule, which will allow the federal agency to collect...
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