On April 2, 2018, CMS released the Contract Year 2019 Final Rules for Medicare Advantage (MA) and Part D (the MA Final Rule), incorporating changes that support CMS’ stated commitment to supporting flexibility and efficiency throughout the MA and Part D Programs.… Continue reading this entry
Tags: Centers for Medicare and Medicaid Services, CMS, Medicare Advantage, Medicare Advantage (MA), Part D
By now, providers are very familiar with Medicare recovery audit contractors, or RACs – the private companies who have authority to review medical records at a moment’s notice. For every dollar they opine has been improperly billed, the RACs recover a share of the bounty, creating a perverse incentive and an appeal process years behind … Continue reading this entry
Tags: Centers for Medicare & Medicaid Services, Medicare, Medicare Advantage, Recovery Audit Contractors (RAC), Risk Adjustment Data Valuation (RADV)