The Medicare Fund Recover insurers can be on the hook for billions from the changes in the study

The Medicare Fund Recover insurers can be on the hook for billions from the changes in the study

CMS wants to make some simple changes in the way it looks at the methods used for Medicare Advantage plans, which can leave insurers on the hook for billions of dollars.

In an agreement last week, which is most effective in expanding the use of the telephone, CMS said it wants to stop using "tax calculations" for its search, which has been used in history to Ensure the process of Medicare and Advantage. Adjust payment.

He also warned that he wanted to start re-investing in a Medicare Riba system based on the system that came back in 2012. The project will further complement the results of an enrollees product according to the population population, # 39; a. Additionally, CMS wants to use these changes to return to 2011. Reunion with each other, changes may be expensive and expensive for the Medicare Advantage health system, experts say.

"You are considering the possibility of raising money for the Medicare health system," said William Horton, a partner at lawyer Jones Walker.

In the year 2017, CMS estimated that it had invested 14.4 billion dollars in appropriate funds for the development of skills. He predicted that the "reform and balance" changes would result in $ 20 billion in the Medicare program in 2020 and $ 381 per year.

Health care providers have already turned on the changes. Matt Eyles, President of the United States and President of the US Department of Health, said in a statement that "this process re-established the long-term status of governments and other non-governmental organizations. the stakeholders think they are legal receivers. "

This process came when CMS and the Ministry of Justice were continuing to try to restore what they had to do with payment to the Benefits of Medicare Advantage. The US Department of Justice has taken the United States Court to challenge the use of Medicare Advantage, and recently suspected that they had Anthem. He is also studying disaster reduction programs in Aetna, Cigna and Humans, although no allegations are made.

Jessica Smith, Vice President of Health Research and Solving Problems in Gorman Health Group, said CMS and # 39 suggest that audits would be effective and health plans should be prepared.

The CMS has investigated profit-making insurers every year by comparing intelligence codes including insurance fees for the medical record, but the commission did not have the right to reimburse the money, says Smith.

It is examined to prevent sellers from increasing their health status for members of the government to receive government funding. CMS is paid to a Medicare Food Consumer Depot based on Medicare's payment for personal use. Most importantly, the patient is allergic, the largest to pay for the plan, giving priority plans to the health care of their members.

In 2012, CMS published a methodology to calculate the pricing value of the enrollees product from each of the published use systems and then added a great error throughout the program. After that, tax calculations will be used to calculate any errors in Medicare's available medical information, which are used in the Medicare Advantage Fund. The CMS has used this approach to review in 2011, 2012 and 2013, but the results have not yet been completed and no payment has been made using this system.

But now CMS wants to gather. "People have a great deal of responsibility to support millions of dollars,

a]In the case of unpaid persons,

who buy them, "he said in a planned constitution." Also, people have a lot of money to offer,

who bought them,

a]in ku]a]yes, in the future, which can be improved by refinancing,

a]in ku]a]unpaid. "

The CMS Institute stated that it would not be surprising to advise healthcare consultants, noting that "appointing MA parties in notice" in 2012 that these changes would come. The agency also said that it examined the reforms to find out and find that Medicare's basic error does not lead to a bankruptcy error in the Benefit Benefit Program, so it recommended removing the fat pick up.

These findings might ask questions about the Federal High Court's decision last month to eliminate the "2014 Grants Administration" in the challenge of UnitedHealthcare. This law requires Adurers users to raise government revenues within 60 days of finding out whether they will be taken against Shari'a law and that crime can be done only , damages and additional ransom. But the situation is not possible to change because of the new law.

Changes that are transformed are amazing and easy to use can be detestable to the health insurance insurers, Horton said. He predicted that health systems were good enough to score the success they had to make changes.

"There is a good reason that the change (rules) is going on, and that people are not in a position to fit them; but it's wrong to go back now and say that these programs could be a waste of millions of dollars. Faith in true faith deserves, "Horton said.