Recent CMS audits of Medicare Advantage health plans uncovered roughly $12 million in net overpayments. Moreover, CMS said it was going to extrapolate the payment error rates across all Medicare Advantage plans to recoup an estimated $650 million. As a result, Medicare Advantage plans are now auditing the companies with whom they work—including HME providers. Audit expert Wayne van Halem, president and founder of the audit consulting firm The van Halem Group, discusses what this means for the industry and how providers should respond.
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