Concern Raised Over Estimated Billions Shown in Chart Reviews

The Office of the Inspector General of the United States undertook a recent study in which they reviewed a myriad of Medicare Advantage organizations (MAOs). There were concerns that these MAOs may be using chart reviews to increase the intake of their risk adjusted payments in an inappropriate manner. To those not in the know, unsupported risk adjusted payments are a major factor behind improper payments in the Medicare Advantage program (MA for short). In 2018 alone, the MA coverage to 20 million beneficiaries to the tune of $210 billion.

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