General Question for the Week of October 3, 2016

General Compliance Question of the Week


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


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).

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