6+ hour, 59+ min ago  (357+ words) A former Aetna risk-adjustment coding auditor, suing on behalf of the federal government, alleged Aetna was paid an inflated monthly payment amount by the Centers for Medicare & Medicaid Services (CMS) as a result of the alleged upcoding. Under the terms…...

1+ mon, 1+ week ago  (624+ words) The budget bill signed into law on Feb. 3 includes changes to the Outpatient Prospective Payment System (OPPS), which the Centers for Medicare & Medicaid Services (CMS) uses to handle payment for hospital outpatient department services. Current TMA Board of Trustees Chair…...