INSURASALES

Tag: risk adjustment

Algorithms Enhance Fairness in Medicare Advantage Risk Adjustment Payments

New algorithmic approaches improve fairness in Medicare Advantage payment models, promoting equitable spending for minority beneficiaries without reducing predictive accuracy.

Senators Propose Bill to Tighten Medicare Advantage Risk Adjustment, Curb Overpayments

Senators introduce bipartisan bill targeting Medicare Advantage overpayments by refining risk adjustment and supporting CMS audits to enhance program integrity and save Medicare billions.

AI and Legislative Actions Aim to Address Medicare Advantage Coding Disputes

Explore how AI innovations and the No UPCODE Act seek to resolve Medicare Advantage coding controversies, improving risk adjustment and compliance.

CMS Expands Medicare Advantage Audits Impacting Major Health Insurers

CMS expands Medicare Advantage audits from 2018-2024, intensifying compliance demands and financial scrutiny for major health insurers like UnitedHealth, CVS, and Humana.