Big well being insurers who spoke on the J.P. Morgan Healthcare Convention are gearing as much as battle the Biden administration as soon as it finalizes its plan for auditing Medicare Benefit, which is anticipated to occur subsequent month.
Executives from Humana, Centene, and CVS Well being-Aetna aired issues concerning the forthcoming remaining rule on the audits, generally known as threat adjustment information validation, or RADV. Medicare has been mulling the replace for years, however the course of has been held up by business opposition. Enhanced audits might probably pressure insurers to repay tens of tens of millions of {dollars} for a single audit. Lately, although, Medicare gave itself a agency deadline; It’ll concern a remaining rule on the matter by Feb. 1.
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