General Question for the Week of October 3, 2016

General Compliance Question of the Week

Question:

Do the Medicare fee-for-service audit and quality program flexibilities apply to Medicare Advantage?

Answer:

No, they apply only to Medicare fee-for-service claims from physicians or other practitioners billed under the Medicare Fee-for-Service Part B physician fee schedule. Medicare Advantage risk-adjustment payment and audit criteria remain unchanged, according to the Centers for Medicare & Medicaid Services (CMS).

Disclaimer: Every reasonable effort was made to ensure the accuracy of this information at the time it was published. However, due to the nature of industry changes over time we cannot guarantee its validity after the year it was published.