Tag: Insurance Audits

Medicare Advantage Audits Reveal Inflated Health Conditions for Payments

Recent HHS OIG audits uncover inflated health conditions in Medicare Advantage plans by Humana and UnitedHealthcare, raising concerns over payments and compliance.

Understanding Medicare Advantage Risk Adjustment

Explore the complexities of Medicare Advantage risk adjustment, AI's role, and compliance challenges facing insurers. Learn about emerging accountability frameworks.