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Where To Report Waste
Fraud, Abuse, Or Retaliation
Where To Report Waste Fraud, Abuse, Or Retaliation

The Inability To Identify Denied Claims in Medicare Advantage Hinders Fraud Oversight

Submitting OIG: 
Department of Health & Human Services OIG
Date Issued: 
Monday, February 27, 2023
Agency Reviewed / Investigated: 
Department of Health & Human Services
Submitting OIG-Specific Report Number: 
OEI-03-21-00380
Component, if applicable: 
Centers for Medicare & Medicaid Services
Centers for Medicare and Medicaid Services
Location(s): 
United States
Type of Report: 
Inspection / Evaluation
Questioned Costs: 
$0
Funds for Better Use: 
$0
Number of Recommendations: 
1
View Document: 
AttachmentSize
PDF icon OEI-03-21-00380.pdf1.44 MB

Related Open Recommendations

Recommendation Number Recommendation Status Significant Recommendation Additional Details
23-E-03-012.01 Open No
CMS should require MAOs to definitively indicate on MA encounter data records when they have denied payment for a service on a claim.
Displaying 1 of 1 Recommendations