Policymakers are exploring reforms to address shortcomings of risk adjustment that inflate Medicare Advantage payments and ...

Joint customers can improve coding accuracy, strengthen compliant submissions, and strengthen RAF integrity with Penguin Ai's HCC Coding & Risk Adjustment Snowflake Native App PALO ALTO, Calif., Jan.

The MarketWatch News Department was not involved in the creation of this content. Joint customers can improve coding accuracy, strengthen compliant submissions, and strengthen RAF integrity with ...

As CMS-HCC V28 fully takes effect in 2026, healthcare organizations face a structural reset in risk scoring. Planning ...

RAAPID Inc. is proud to announce that the company was recognized by Modern Healthcare as one of the Best in Business of 2025 ...

The insurer turns risk adjustment into its own business, says Sen. Chuck Grassley, chairman of the Senate Committee on the Judiciary.

For example, the No UPCODE Act, introduced by Senators Bill Cassidy (R-LA) and Jeff Merkley (D-OR), would eliminate the use of health risk assessments used to boost coding intensity and utilize two ...

The Trump administration has released proposed payment rates in Medicare Advantage and Part D for the 2027 plan year, ...

On January 14, the Department of Justice (DOJ) announced that five Kaiser Permanente affiliates agreed to pay $556 million to ...

Kaiser Permanente (Kaiser) has agreed to pay $556 million to resolve False Claims Act litigation alleging improper Medicare Advantage risk-adjustment practices, according to the U.S. Department of ...

Jan 12 (Reuters) - Health insurer UnitedHealth Group (UNH.N), opens new tab used aggressive risk-adjustment coding tactics to increase U.S. government reimbursement for patients enrolled in its ...

The probe began after STAT and others reported on UnitedHealth's strategies to boost profits in Medicare Advantage.