News Briefs: July 24, 2023

The HHS Office of Inspector General (OIG) has updated its work plan. Three of the eight new items focus on Medicare Advantage (MA).[1] For one thing, OIG will develop an MA high-risk diagnosis codes tool kit “that will provide highly technical information to assist MA organizations with analyzing the accuracy of the risk adjustment data that they receive from their providers and submit to CMS. We will provide this information as a starting point to allow MA organizations to research enrollees who receive diagnoses that are at high risk for being miscoded and to take appropriate action if needed.” The other two are on MA payments generated by health risk assessments for 2022 and increased payments to MA plans that were reported on physician claims but not confirmed on a concurrent inpatient hospital stay.

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