Posted February 1, 2023
Hospice providers rely on Medicare Advantage (MA) reimbursement to support palliative care, PACE and social determinants programs, among others. Last week, CMS laid out its policy for validating MA plans’ risk adjustment data, which the agency uses to calculate capitation rates. Through the MA Risk Adjustment Data Validation (RADV) program, CMS will be auditing beneficiary medical records to identify potential improper payments.
RADV is designed to ensure that a beneficiary’s diagnoses are supported by their medical documentation.
“CMS is committed to protecting people with Medicare and being a responsible steward of taxpayer dollars,” said CMS Administrator Chiquita Brooks-LaSure. “By establishing our approach to RADV audits through this regulation, we are protecting access to Medicare both now and for future generations. We have considered significant stakeholder feedback and developed a balanced approach to ensure appropriate oversight of the Medicare Advantage program that aligns with our oversight of Traditional Medicare.”
Click here for the full article.
For over 30 years, Corridor has partnered with home health and hospice providers, delivering powerful solutions to support the unique challenges of caring for patients in the home. Our team of operations executives, clinicians, and nationally renowned industry experts have run provider organizations and resolved the same challenges you face.
To receive the most important industry updates, insights and news impacting home health and hospice, please make sure to sign up for our weekly newsletter.