When the Centers for Medicare & Medicaid Services (CMS) pays Medicare Advantage (MA) organizations, they increase the payments when plans enroll sicker people. This is called risk adjustment, and it is an important guardrail to ensure that all people with Medicare have access to MA plans; without risk adjustment, plans would have reasons to avoid … Continue reading Watchdog Estimates $7.5 Billion Medicare Advantage Overpayment from “Questionable” Health Risk Assessments