The Medicare Advantage (MA) Risk Adjustment Data Validation (RADV) audit is a vital process conducted by the Centers for Medicare and Medicaid Services (CMS) to ensure the correctness of payments to MA plans. CMS determines monthly payments based on the health and demographic characteristics of each member,
Read More →The Supreme Court recently denied a health plan’s petition related to the Centers for Medicare & Medicaid Service’s (CMS) Overpayment Rule, which requires Medicare Advantage (MA) organizations to return identified overpayments to CMS within 60 days. In short, this means that the Overpayment Rule remains in effect and
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