Medicare Advantage Audits Estimated to Recover $370M

CMS recently announced it will move forward with a new initiative to reduce errors within Medicare Advantage plans, which is expected to save an estimated $370 million in overpayments for the first audit year.

CMS is required to adjust payments to MA plans, or Medicare Part C, based on the health status of plan enrollees. From fiscal year 2010 to FY 2011, CMS reduced the payment error rate for MA plans from 14.1 percent to 11 percent, a still somewhat-high error rate for a health plan.


The estimated $370 million in overpayment savings is only a projection, and actual recoveries may vary, according to the news release.

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