{"id":16865,"date":"2020-09-23T08:51:29","date_gmt":"2020-09-23T12:51:29","guid":{"rendered":"https:\/\/medicarereport.org\/?p=16865"},"modified":"2020-09-23T08:51:29","modified_gmt":"2020-09-23T12:51:29","slug":"coding-errors-led-to-overpayments-to-medicare-advantage-plans","status":"publish","type":"post","link":"https:\/\/medicarereport.org\/?p=16865","title":{"rendered":"Coding errors led to overpayments to Medicare Advantage plans"},"content":{"rendered":"<p>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\u2019 Office of the Inspector General.\u00a0 The OIG\u2019s 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 <a href=\"https:\/\/www.fiercehealthcare.com\/payer\/oig-coding-snafu-led-to-14m-overpayments-to-ma-plans\">here\u2026<\/a><\/p>\n<p><a href=\"https:\/\/medicarereport.org\/wp-content\/uploads\/2018\/03\/DHS-Office-of-Inspector-General.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignnone size-medium wp-image-9962\" src=\"https:\/\/medicarereport.org\/wp-content\/uploads\/2018\/03\/DHS-Office-of-Inspector-General-300x74.jpg\" alt=\"\" width=\"300\" height=\"74\" srcset=\"https:\/\/medicarereport.org\/wp-content\/uploads\/2018\/03\/DHS-Office-of-Inspector-General-300x74.jpg 300w, https:\/\/medicarereport.org\/wp-content\/uploads\/2018\/03\/DHS-Office-of-Inspector-General.jpg 623w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><\/p>\n<pre><strong>Notice:<\/strong> The link provided above connects readers to the full content of the posted article. The URL (internet address) for this link is valid on the posted date; medicarereport.org cannot guarantee the duration of the link\u2019s validity. Also, the opinions expressed in these postings are the viewpoints of the original source and are not explicitly endorsed by AMAC, Inc.; the AMAC Foundation, Inc.; or medicarereport.org<\/pre>\n","protected":false},"excerpt":{"rendered":"<p>Incorrect diagnosis codes from providers led to a $14 million windfall for some Medicare Advantage plans according to a recent<\/p>\n","protected":false},"author":4,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[32,36,4],"tags":[],"class_list":["post-16865","post","type-post","status-publish","format-standard","hentry","category-cms","category-dhs-oig","category-medicare-fraud"],"_links":{"self":[{"href":"https:\/\/medicarereport.org\/index.php?rest_route=\/wp\/v2\/posts\/16865","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/medicarereport.org\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/medicarereport.org\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/medicarereport.org\/index.php?rest_route=\/wp\/v2\/users\/4"}],"replies":[{"embeddable":true,"href":"https:\/\/medicarereport.org\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=16865"}],"version-history":[{"count":1,"href":"https:\/\/medicarereport.org\/index.php?rest_route=\/wp\/v2\/posts\/16865\/revisions"}],"predecessor-version":[{"id":16866,"href":"https:\/\/medicarereport.org\/index.php?rest_route=\/wp\/v2\/posts\/16865\/revisions\/16866"}],"wp:attachment":[{"href":"https:\/\/medicarereport.org\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=16865"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/medicarereport.org\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=16865"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/medicarereport.org\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=16865"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}