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CMS Released Final Rule on Risk Adjustment Data Validation

The Centers for Medicare & Medicaid Services CMS released the long-delayed final rule on risk adjustment data validation RADV audits of Medicare Advantage MA organizations. CMS promotes the Final Rule as improving program integrity and payment accuracy. ....

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CMS Issues Long-Awaiting Medicare Advantage RADV Final Rule | Sheppard Mullin Richter & Hampton LLP

On January 30, 2023, the Centers for Medicare & Medicaid Services (“CMS”) released the long-delayed final rule on risk adjustment data validation (“RADV”) audits of Medicare Advantage. ....

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Court Rules That

Last year we reported on a class-action lawsuit which alleged that a product described as "brown bread," and which contained oat and rye flakes on the crust and a "no artificial preservatives or flavors" label claim. ....

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CMS Proposes Amendment to Modify Overpayment Rule

CMS new amendment significantly modifies the standard governing identification of overpayments by providers. The Overpayment Rule obliges providers to report and return identified funds that are received to which the provider, after applicable reconciliation. ....

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CMS Proposes Amendment to Overpayment Rule | Steptoe & Johnson PLLC

The Centers for Medicare and Medicaid Services (CMS) has proposed a new amendment that could significantly modify the standard governing identification of overpayments by providers. ....

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