Medical Coding

How Can Medicare Advantage Organizations Prepare for RADV Audits?

August 22, 2023 - Increasing internal audits and implementing additional coding oversight can benefit Medicare Advantage organizations as they manage new auditing regulations, Melissa James, senior consultant at Wolters Kluwer, told HealthPayerIntelligence.  The Medicare Advantage Risk Adjustment Data Validation (RADV) final rule changed how CMS determines payment adjustments for Medicare Advantage...


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MedPAC Calls on Congress to Modify Medicare Advantage Payment Policies

by Victoria Bailey

As Medicare Advantage enrollment grows, the Medicare Payment Advisory Commission (MedPAC) is calling on Congress to address payment and coding differences between Medicare Advantage and Medicare...