May 8, 2021


Advocacy. Mediation. Success.

OIG Audits on Medicare Advantage Plans Continue

On April 19, 2021, the Workplace of Inspector General’s (OIG) Workplace of Audit Companies (OAS) launched the results of an audit done on the accuracy of prognosis codes submitted to CMS by Humana, Inc. for 2015 dates of services. Centered on the audit results, the OIG recommended Humana return a whopping $197.7 million in alleged overpayments and enrich its procedures and strategies to avoid, detect and suitable noncompliance with Federal prerequisites for prognosis codes that are utilized to determine…
By: Epstein Becker & Green