OIG to probe whether Medicare Advantage plans deny post-acute care
(By Rylee Wilson for Becker’s Hospital Review) HHS’ Office of Inspector General will audit Medicare Advantage plans’ use of prior
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DHS -Office of Inspector General
Feds to investigate integrated Part D plans, PBMs
(By Rylee Wilson for Becker’s Hospital Review) HHS’ Office of Inspector General will investigate the impact of vertically integrated Medicare
Read More10 payers audited for Medicare Advantage overpayments in 2023
(By Rylee Wilson for Becker’s Hospital Review) OIG audits found over $213 million in estimated Medicare Advantage overpayments in 2023.
Read MoreOIG: Centene subsidiary received estimated $5.1M in Medicare Advantage overpayments
(By Rylee Wilson for Becker’s Hospital Review) SelectCare of Texas, a Centene subsidiary, received an estimated $5.1 million in net
Read MoreFeds ramp up Medicare Advantage scrutiny
(By Rylee Wilson for Becker’s Hospital Review) The federal government is ramping up scrutiny of Medicare Advantage plans. In October,
Read MoreOIG: Aetna received estimated $25.5M in Medicare Advantage overpayments
(By Rylee Wilson for Becker’s Hospital Review) Aetna received $632,070 in overpayments for Medicare Advantage claims from 2015 to 2016,
Read MoreVirginia paid $21.8M for care for Medicaid enrollees that had already died, OIG audit finds
(By Rylee Wilson for Becker’s Hospital Review) Virginia made capitation payments for thousands of Medicaid enrollees after their deaths, an
Read MoreMedicaid managed care organizations deny 1 in 8 prior authorization requests: OIG
(By Rylee Wilson for Becker’s Hospital Review) HHS’ Office of Inspector General raised concerns about the rate of prior authorization
Read MoreOIG: Medicare overpaid up to $888M for genetic tests
(By Rylee Wilson for Becker’s Hospital Review) Medicare could have overpaid hundreds of millions for genetic testing from 2018 to
Read More6 Medicare Advantage plans audited for upcoding in the last six months
(By Rylee Wilson for Becker’s Hospital Review) Audits published in the last six months found almost $32 million in overpayments
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