Miscoded diagnoses may cause CMS to pay Medicare Advantage (MA) organizations improper amounts. To emphasize the need for accurate coding to avoid increased risk-adjusted payments, the OIG is conducting a nationwide audit to determine whether these diagnosis codes, as submitted by MA organizations to CMS for use in CMS's risk-adjustment program, complied with Federal requirements. Read more about this new work plan item.
The Consumer Finance Protection Bureau on Sept. 21 outlined proposals aiming to end "coercive debt collection tactics, clean up inaccurate data, and improve credit score predictiveness." A 2022 report
UnitedHealthcare is cutting 20 percent of its prior authorizations in two waves. The first cuts take effect Sept. 1 and the second phase goes into effect Nov. 1. Here are the cuts UnitedHealthcare is
Recent healthcare fraudsters in the news: 1. Bridgeport, Conn.-based federally qualified health center Optimus Health agreed to pay more than $470,000 to settle improper billing allegations. 2. A fede