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Home Health & Hospice Week

Industry Note:

OIG Targets Inappropriate Managed Care Denials

Published on Fri Jun 22, 2018

In addition to looking at home health episodes that barely exceed the LUPA threshold, the HHS Office of Inspector General also plans to examine the issue of “Inappropriate Denial of Services and Payment in Medicare Advantage,” according to its latest Work Plan update. “A central concern about the capitated payment model used in Medicare Advantage is the incentive to inappropriately [...]
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