Risk Adjustment Fraud
This archive displays posts tagged as relevant to risk adjustment fraud in managed care programs You may also be interested in our pages:
The Calm Before the Storm: Enforcement Trends in Risk Adjustment: DOJ and the False Claims Act
Posted 11/17/15
Presentation by Mary Inman at SSN's Medicare Risk Adjustment & Revenue Management Conference in Miami. (November 17, 2015). Download presentation; Click here to view the agenda.
Medicare Advantage Plan Loses Members, Responds with Plans to Raise Risk Adjustment Scores
Posted 09/21/15
The Compliance & Ethics Blog (September 21, 2015)
Click here to read the article.
Medicare Part C: Fighting Back Against Risk Adjustment Fraud
Posted 06/26/15
Health insurance companies that participate in the Medicare Managed Care program (also known as Medicare Advantage or Medicare “Part C”) routinely complain about cuts to their reimbursement rates – even in years, like this one, where the reimbursement rates are actually increased. At the same time, reports indicate that insurers are “leaning heavily on their Medicare business” and “signal[ing their]...
Medicare Risk Adjustment: Financial Incentives May Lead to Bad Practices
Posted 10/1/12
AAPC Coding Edge (October 2012), 30-32
Click here to read the article.
Beyond RADV: Does Your Plan's Risk Adjustment Strategy Run Afoul of the False Claims Act
Posted 02/13/12
Presented at the HCCA Managed Care Compliance Conference (February 13, 2012). Click here to view the presentation.