NLM Digital Collections

Search

Start Over Subjects Medicare Part C -- economics ✖Remove constraint Subjects: Medicare Part C -- economics Subjects Government Regulation ✖Remove constraint Subjects: Government Regulation

1. Billions in estimated Medicare Advantage payments from diagnoses reported only on health risk assessments raise concerns

Publication:
[Washington, D.C.] : U.S. Department of Health and Human Services, Office of Inspector General, September 2020
Subject(s):
Fraud -- prevention & control
Government Regulation
Medicare Part C -- economics
Risk Adjustment -- economics
United States
United States. Department of Health and Human Services

3. Medicare Advantage organizations are missing opportunities to use ordering provider identifiers to protect program integrity

Publication:
Washington, D.C. : U.S. Department of Health and Human Services, Office of Inspector General, April 2021
Subject(s):
Data Analysis
Fraud -- prevention & control
Government Regulation
Medical Order Entry Systems
Medicare Part C -- economics
United States
United States. Department of Health and Human Services

4. Some Medicare Advantage companies leveraged chart reviews and health risk assessments to disproportionately drive payments

Publication:
Washington, D.C. : U.S. Department of Health and Human Services, Office of Inspector General, September 2021
Subject(s):
Government Regulation
Health Status Indicators
Insurance Carriers -- legislation & jurisprudence
Medical Records -- economics
Medicare Part C -- economics
Quality of Health Care -- legislation & jurisprudence
United States
United States. Department of Health and Human Services

5. Some Medicare Advantage Organization denials of prior authorization requests raise concerns about beneficiary access to medically necessary care

Publication:
Washington, DC : U.S. Department of Health and Human Services, Office of Inspector General, April 2022
Subject(s):
Government Regulation
Insurance, Health, Reimbursement -- economics
Medicare Part C -- economics
Medicare Part C -- organization & administration
Prior Authorization -- economics
Time-to-Treatment
United States
United States. Department of Health and Human Services

6. Medicare Advantage: Continued monitoring and implementing GAO recommendations could improve oversight : testimony before the Subcommittee on Oversight and Investigations, Committee on Energy and Commerce, House of Representatives

Publication:
Washington, DC : United States Government Accountability Office, June 28, 2022
Subject(s):
Fraud -- prevention & control
Government Regulation
Medicare Part C -- economics
United States
Centers for Medicare & Medicaid Services (U.S.)