OIG Calls for More Oversight of Medicare Advantage Risk-Adjusted Payments
- September 24, 2021
A new Department of Health and Human Services Office of Inspector General (OIG) report released this week underscores concerns that some Medicare Advantage (MA) plans may be using chart reviews—a review of a beneficiary’s medical record to identify diagnoses that a provider did not submit or submitted in error—and health risk assessments (HRAs)—where a health care professional collects information from beneficiaries to identify gaps in care—to improperly maximize risk-adjusted payments.
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