Part B Insider (Multispecialty) Coding Alert

Physician Note:

CMS Rolls Out New Medicare Advantage Auditing Plan

Plus: Dallas Physician Arrested As Part of $375 Million Scheme.

CMS has been auditing Medicare Advantage (MA) plans since 2008, so practices may not be surprised to hear that those audits are still taking place. What is new, however, is the fact that CMS recently instituted a new initiative to slash errors in the MA program.

By tweaking the audit methodology in a new way, CMS hopes to recover an estimated $370 million in overpayments. "Fighting fraud, improving payment accuracy, and saving money for Medicare is one of our top priorities," said CMS Acting Administrator Marilyn Tavenner in a Feb. 24 statement. "CMS will use a new method of auditing Medicare Advantage plans that improves program integrity and reflects public input."

To read more about how CMS intends to calculate the results, visit http://www.cms.gov/Plan-Payment/02_PaymentValidation.asp.

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