Providers should prepare for the fallout following a recent CMS announcement that it will take a more aggressive approach to auditing Medicare Advantage plans.
The Centers for Medicare & Medicaid Services (CMS) recently announced it will take a more aggressive approach to Medicare Advantage plan audits. Beginning immediately, CMS will conduct annual audits of each of the approximately 550 MA plans available to healthcare consumers, up from the 60 or so it currently conducts each year.
While MA payers will feel the direct impact of heightened regulatory scrutiny, the move has major implications for revenue cycle leaders and their health systems.
See the infographic below to learn how increased action from CMS will affect provider revenue cycles, or read more here.
Luke Gale is the revenue cycle editor for HealthLeaders.
KEY TAKEAWAYS
CMS currently audits 60 or so Medicare Advantage (MA) plans each year, but recently announced it will immediately begin annual audits of all eligible Medicare Advantage (MA) plans each year.
Increased regulatory scrutiny for MA plans could translate to more medical record requests and post-payment reviews for providers.