Risk Adjustment Compliance and ICD-10 Diagnosis Code Accuracy: Three Areas of Concern Identified by the OIG 

One reason a comprehensive risk adjustment compliance program is critical is that identified overpayments may be recouped through risk adjustment data validation (RADV) audits. Given potential financial and reputational harm due to ICD-10 diagnosis code inaccuracies, health plans and risk-bearing provider groups are becoming increasingly proactive in

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CMS Updates to Part D Member Materials for CY 2023 

CMS released two time-sensitive HPMS memos on September 6, 2022:   These changes impact Part D sponsors, Medicare Advantage and Part D sponsors, Medicare-Medicaid Plans, and Minnesota Senior Health Options plans for the upcoming Annual Enrollment Period (AEP).  The Inflation Reduction Act of 2022 was signed into

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