Medicare Advantage Compliance Audit of Diagnosis Codes That MMM Healthcare, LLC, (Contract H4003) Submitted to CMS

Date Issued

Tuesday, August 13, 2024

Submitting OIG

Department of Health & Human Services OIG

Agencies Reviewed/Investigated

Department of Health & Human Services

Report Number

A-04-20-07090

Report Type

Audit

Agency Wide

Yes

Number of Recommendations

Questioned Costs

$165,312

Funds for Better Use

Report updated under NDAA 5274

External Link

Open Recommendations

This report has 2 open recommendations.

Recommendation Number	Significant Recommendation	Recommended Questioned Costs	Recommended Funds for Better Use
24-A-04-095.01	No	$165,312	$0
We recommend that MMM Healthcare, LLC, refund to the Federal Government the $165,312 of net overpayments.
24-A-04-095.02	No	$0	$0
We recommend that MMM Healthcare, LLC, continue to improve its policies and procedures to prevent, detect, and correct noncompliance with Federal requirements for diagnosis codes that are used to calculate risk-adjusted payments.