MediFormatica Daily Digest – Friday, April 14, 2023 – (27 posts)

In todays fast-paced world, it is easy to miss out on important information, especially if you are trying to keep up with a lot of different sources. That is where the daily digest comes in – it is a tool that compiles all the posts created on the previous day, providing you with a convenient summary of everything that happened so you can stay informed, educated, and engaged with the Digital Health world around you.

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Retrieving Billions in Overpayments by CMS

Retrieving Billions in Overpayments by CMS

Amid swirling accusations that Medicare Advantage Organizations (MAOs) are overbilling the U.S. government and calls for better oversight, the Centers for Medicare & Medicaid Services announced in early February that it would investigate overbilling by those plans. They expect to recoup 4.7 billion dollars through this program.
This article focuses on the relatively young technologies that enable CMS to uncover overbillings, whether they be errors or fraud. The article is based on an interview with Kel Pults, chief clinical officer and vice president of MediQuant. A future article will explain how Medicare Advantage plans are trying to improving data collection and reporting,…

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