Fierce Healthcare March 8, 2022
NASHVILLE, Tenn. —A key Department of Health and Human Services (HHS) watchdog warned that a lack of follow-up care for Medicare Advantage (MA) patients is a red flag that could trigger whether an error or fraud has occurred.
Officials with HHS’ Office of Inspector General (OIG) shared during the RISE 2022 National Conference in Nashville, Tennessee, Tuesday how they audit health plans to root out fraud and waste in coding, which has become a major source of criticism in the MA space.
In the past couple of years, OIG has implemented audits of MA plans to look at risk adjustment payments, chart reviews and health risk assessments for any anomalies.
What triggered questions from the auditors...
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