Tag:audit
Medicare Advantage Audits Reveal Alleged Rampant Upcoding
Kaitlin Lavin Executive Editor Loyola University Chicago School of Law, JD 2017 Last month, the Center for Public Integrity obtained over three-dozen new Medicare Advantage (MA) audits through a lawsuit brought under the Freedom of Information Act. The audits indicate that overcharging is still a pervasive problem in the MA Program because Medicare Advantage …
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The New Medicaid Managed Care Rule and Its Effects on Compliance Programs
Kaitlin Lavin Executive Editor Loyola University Chicago School of Law, JD 2017 The Centers for Medicare and Medicaid Services (CMS) recently published a new rule for state contracts with Medicaid Managed Care Organizations (MCO). Medicaid MCOs provide comprehensive services to beneficiaries for capitated payments. The effective date of the rule was July 5, 2016. …
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