Coding errors led to overpayments to Medicare Advantage plans

Incorrect diagnosis codes from providers led to a $14 million windfall for some Medicare Advantage plans according to a recent audit by the Department of Health and Human Services’ Office of the Inspector General.  The OIG’s audit explored Medicare beneficiaries who were covered under traditional Medicare for one year and then choose to enroll in Medicare Advantage the next year; CMS pays MA plans higher rates for these transferred enrollees for one year, and identified several diagnosis codes that were at high risk of being miscoded and resulting in inaccurate payments. Read article here…

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