April, 2023
OIG's Expanded Oversight of Medicare Advantage Risk Adjustment: Implications for Managed Care Organizations. Since 2021, 24 OIG audit reports identified more than $400 million in overpayments, with approximately 72% of audited HCCs not validated / supported within medical documentation.

Stay Ahead of Mental Health Parity Audit Risks with Updated Benefit Documents. During audits, plans have discovered that their NQTL comparative analysis documents are outdated or incorrect, leading to challenges to rectify inaccuracies and minimize impact on members. 

Navigating the 2023 CMS Program Audit: Are You Ready? CMS has initiated routine program audits by sending engagement letters to Medicare Advantage organizations, prescription drug plans and Medicare-Medicaid plans.

The plan, serving more than 50,000 individual and small-group members, recognized the negative impact that incomplete data submissions would have on finance.
Provider access and availability surveys are a critical tool for health plans to meet regulatory and contractual requirements, control costs and improve quality of care. Read about how ATTAC helped a large plan increase member access to timely care by 20%.