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Audit the Medicare Payors…It’s Not At all times the Suppliers That Commit Fraud

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You can view the original post here At present, I'm going to put in writing about America’s managed care drawback. We all the time discuss suppliers getting audited. It's about time that the payors get audited. Particularly, for Medicaid, States contract with managed care organizations, that are pay as you go, and, for Medicare, Medicare Benefit corporations, that are pay as you go. Managed care in Medicare is MA organizations. Managed care in Medicaid is MCOs. These MCOs and MAs should be held accountable for the misuse of funds. At present, capitated, managed care is the dominant method by which states ship providers to Medicaid enrollees. And MA is turning into the dominant solution to obtain Medicare. Underneath these pay as you go packages, these non-public corporations are paid a flat payment monthly relying on the variety of customers to supply no matter care is required for sufferers based mostly on age, gender, geography and well being danger e...