The RADV program is a tool CMS uses to identify and recover overpayments to MA. Only a few months ago, CMS touted its commitment to beefing up this program, leveraging the 2023 final rule. Through ...

The Office of the Inspector General (OIG) has been cracking down recently on Medicare overpayments to hospitals. Following an audit report done on March 13, OIG found that Boston's Brigham and Women's ...

Six takeaways from the CMS administrator’s appearance at a D.C. think tank Monday — including who’s set to be the next ...

Medicare Advantage (MA), Medicare’s popular system of private health plans, is in the hot seat. During a recent congressional hearing, members and witnesses expressed concern about MA plans’ efforts ...

Pursuant to Section 6402(a) of the Patient Protection and Affordable Care Act (PPACA), the Centers for Medicare and Medicaid Services (CMS) published a proposed rule for reporting and returning ...

While headlines warn that the Hospital Insurance Trust Fund2 will run out in 2033, the real danger comes from a different part of the program: Supplementary Medical Insurance. Unless Congress makes ...

On Thursday, Texas Judge Reed O’Connor threw out a Biden-era rule that would have recouped billions of dollars in overpayments to MA plans.

Has the nation’s largest health care company exploited incentives in the federal insurance program for seniors?

Recovery audit contractors identified about 1.1 million Medicare overpayments during fiscal years 2010 and 2011 — half of all claims they reviewed. Just over 6 percent of the overpayment ...

Don't Toss Your Medicare Financial Records Older Anesthesiologists Get Sued More Often Is It a Bad Idea for Each State to Determine Its Own Essential Health Benefits? References Is It a Bad Idea for ...

Medicare trustees estimate that more than 33 million Medicare beneficiaries are currently on free-standing Part D plans in 2025. Along with the overpayment repayment change, Social Security saw a ...