Medicare Compliance & Reimbursement
Feds Introduce No Upcode Act to Combat MA Issues
As Medicare Advantage plans continue to come under the microscope, it shouldn’t come as a surprise that legislators recently launched plans to improve patient care and cut costs. Details: On March 27, Senators Bill Cassidy, MD, (R-Louisiana) and Jeff Merkley (D-Oregon) introduced the No Unreasonable Payments, Coding, or Diagnoses for the Elderly (No UPCODE) Act. The bill aims to change the way beneficiaries are assessed in Medicare Advantage plans and decrease overpayments. The Senators point to Medicare Advantage’s risk-adjusted standard rate, which pays providers based on the health of the beneficiary, indicates a release on the bill. “Because of this, Medicare Advantage plans have a financial incentive to make beneficiaries appear sicker than they may be to receive a higher Medicare reimbursement,” the legislators say. Review the bill at www.cassidy.senate.gov/imo/media/ doc/2023.03.27 Upcoding Legislation v41.pdf and the press release at www.cassidy.senate.gov/newsroom/ press-releases/cassidy-merkley-introduce-bill-to-better-assess-medicare-patient-health-avoid-overpayments.
Medicare Compliance & Reimbursement
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