Articles and Blogs

In a move likely to ignite strident industry opposition, on January 30, 2023, the Centers for Medicare & Medicaid Services (“CMS”) announced finalization of its rule on Medicare Risk Adjustment Data Validation (“RADV”) audit methodology and resulting collection of overpayments from Medicare Advantage Organizations (“MAOs”). Experts estimate that the final rule will result in... READ MORE

In keeping with the trends of the commercial market, on April 22, 2019, the Centers for Medicare & Medicaid Services (“CMS”) announced opportunities to participate in new direct contracting models under Medicare’s Part A and Part B fee-for-service program. CMS intends to focus these models particularly on primary care coordination for medically complex and... READ MORE