Health Affairs This Week cover image

Medicare Advantage Targeted By CMS For Overpayment

Health Affairs This Week

00:00

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.

Transcript
Play full episode

The AI-powered Podcast Player

Save insights by tapping your headphones, chat with episodes, discover the best highlights - and more!
App store bannerPlay store banner
Get the app