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HHS to look at MA risk adjustment as upcoding in spotlight

November 17, 2022


Despite criticisms over inaction, the HHS is aware of the flurry of fraud in the Medicare Advantage program that’s costing the government billions of dollars a year, and is thinking about how to curb it, department officials said at HLTH this week.

The HHS is currently reviewing public comments on how to improve MA, including strategies for paring back on fraud and abuse, and plans to make policies based on the evidence, HHS Secretary Xavier Becerra said Tuesday. That could include changing the risk adjustment formulas.

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