The Medicare Payment Advisory Commission, an independent federal agency that advises Congress on Medicare, is considering a recommendation to establish national guidelines for hospital emergency ...

Medicare Advantage remains an attractive option for Medicare beneficiaries, and enrollment has increased substantially, by 66 percent in the past six years. Also increasing, it seems, is coding ...

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

This article has been updated. Upcoding — when payers and providers assign inaccurate billing codes to increase reimbursement — cost an estimated $2 billion in 2014 in excess public payments to ...

An analysis of differential coding patterns between Medicare Advantage (MA) and Traditional Medicare (TM) plans estimated how much coding differs between insurers and how much extra revenue insurers ...