Compliance & Payment Integrity
Expert articles and analysis related to compliance & payment integrity.
AI Summary â Last 7 Days
Synthesis:
In the past week, compliance and payment integrity tensions have sharpened as CMS finalized a sizable 2.48% Medicare Advantage rate increase for 2027, well above its initial proposal, amid political sensitivity over senior coverage and industry backlashâreverberating through risk adjustment, payment integrity, and plan/provider negotiations [CMS finalizes higher MA rates]. At the same time, CMS has moved to âhold harmlessâ ACOs from suspect Medicare billing practices, a move praised by leading ACOs but raising questions about future program oversight and fraud safeguards [[ACOs laud federal move to address suspect billing](https://news.google.com/rss/articles/CBMilgFBVV95cUxQM2V5NC1VRnhZM3pjWUUtNmNRTFptaWMydmJabFdnSFRGY0Rxb2Y1WmlUTFlqUlo5Y2RrcGRKSGRpNklBMXljT2tkN0ZlMlF2SmVvcm9lV2Ixc2V0cUZqUWFPQlYyczZ1MmRmQnhBZEx1VWxFeFlXRVljWHV1eXhxUmIwMjF2Y3RwbHplRUhMZXRZeHZCZ0
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Former Intensive Care Nurse Indicted, Charged with Prescription Drug Fraud - oig.hhs.gov
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Former Greeneville Caregiver Indicted, Charged in Vulnerable Adult Abuse Investigation - oig.hhs.gov
Former Greeneville Caregiver Indicted, Charged in Vulnerable Adult Abuse Investigation  oig.hhs.gov
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Advanced Urology and Jitesh Patel will pay $14 million to settle False Claims Act case involving allegations of fraudulent billing and unnecessary medical procedures  oig.hhs.gov
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Trinity Hospital Agrees to Pay $1.7M to Resolve Alleged Stark Law Violations  oig.hhs.gov