tci Medicare Compliance & Reimbursement - 2004 Issue 15

Managed Care: Are Plans Doing The Right Thing With BIPA Funding?

The OIG may be checking the record to make sure.Did your payment rates increase under the Benefits Improvement Plan Act of 2000?  If so, you may be called on to account for how any extra federal dollars were spent. That was the objective of an audit of Missouri-based Mercy Health Plans. The HHS Office of Inspector General wanted assurance that changes to the plan's 2001 adjusted community proposal rate were in fact legit -- and that extra funding benefited beneficiaries, not the MCO's bottom line.To find out, auditors inspected cover letters submitted by Mercy in...

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