
Medicare Advantage Targeted By CMS For Overpayment
Health Affairs This Week
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Medicare Payments - Is Medicare Paid More Than Fee for Service?
MA plans can add diagnoses by doing what they call chart reviews, or more often use software to scour the electronic medical records for additional diagnoses that may be indicated by patient symptoms. CMS says research and audits have shown many of these diagnoses are just not attached to any provided service and not valid. MA plans say they report more diagnoses than comparable patients in fee for service.
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