One company in particular was flagged for reporting a high number of at-home assessments for a small group of conditions, which the report called, "unusual."
A new investigation by the Department of Health and Human services (HHS) has ended with a recommendation for tighter oversight of some Medicare Advantage (MA) plans—which HHS said have submitted claims resulting in $9.2 billion in overpayments, using 2016 data.
The investigation by the HHS' Office of the Inspector General (OIG) focused on MA plans, which are private plans used by 40% of Medicare beneficiaries (25 million enrollees) in the U.S. The study looked at risk-adjusted payments, which is a way that HHS provides additional payments for patients who may have more expensive conditions.
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