DHS -OIG – Page 3 – medicarereport.org

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CMS DHS -OIG Health Care Finance Medicare Advantage

10 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

Eileen Cook December 5, 2023December 5, 2023 CMS, DHS -Office of Inspector General, Healthcare Costs, Healthcare Finance, Medicare Advantage, Medicare Advantage Audits, Medicare Advantage Overpayments

DHS -OIG Medicare Advantage

OIG: 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

Eileen Cook December 4, 2023December 4, 2023 CMS, DHS -Office of Inspector General, Medicare Advantage, Medicare Advantage Overpayments

CMS DHS -OIG Medicaid

OIG: 14 states paid managed care organizations $249M for deceased Medicaid enrollees

(By Rylee Wilson for Becker’s Hospital Review ) Fourteen states gave managed care organizations payments for Medicaid enrollees for months

Eileen Cook December 1, 2023December 1, 2023 CMS, Deceased Medicaid Enrollees, DHS-OIG, HHS Inspector General’s Office Audit, Improper Payments, Medicaid, Medicaid Managed Care

CMS DHS -OIG Health Care Finance HHS Medicare Advantage Medicare Fraud; Illegal Activities

Feds 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

Eileen Cook November 13, 2023November 13, 2023 CMS, DHS -Office of Inspector General, False Claims Act, Healthcare Costs, Medicare Advantage

CMS DHS -OIG Health Care Finance Medicare Advantage

4 recent Medicare Advantage overpayment cases

(By Rylee Wilson for Becker’s Hospital Review ) The Cigna Group will pay over $170 million to settle allegations of

Eileen Cook October 24, 2023October 24, 2023 CMS, DHS-OIG, Healthcare Costs, Medicare Advantage, Medicare Advantage Overpayments

DHS -OIG Health Care Finance Medicare Advantage

OIG: 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

Eileen Cook October 6, 2023October 6, 2023 DHS -Office of Inspector General, Healthcare Finance, Medicare Advantage, Medicare Advantage Overpayments

DHS -OIG Health Care Finance Medicaid

Virginia 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,

Eileen Cook July 26, 2023 Capitation Payments, DHS -Office of Inspector General, Healthcare Finance, Medicaid, Virginia

DHS -OIG Health Care Finance Medicare Advantage

5 Medicare Advantage plans audited for upcoding in 2023

(By Rylee Wilson for Becker’s Hospital Review ) Audits from HHS’ Office of Inspector General published in the first half

Eileen Cook July 21, 2023July 21, 2023 HHS Inspector General’s Office Audit, Medicare Advantage, Medicare Advantage Overpayments, Upcoding

DHS -OIG Medicaid

Medicaid 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

Eileen Cook July 20, 2023 DHS -Office of Inspector General, Medicaid Managed Care, Prior Authorization