Probing the ICD-10 Impact on CMS-HCC Risk Adjustment

Are there significant risks of potential fraud and abuse with Medicare Advantage (MA) by plans, vendors, and providers, with an emphasis on ICD-10-CM’s impact on Centers for Medicare & Medicaid Services Hierarchical Condition Category (CMS-HCC) risk adjustment?

Evidently, the Office of Inspector General (OIG) for the U.S. Department of Health and Human Services (HHS) believes there are. Recently, Christi A. Grimm, Inspector General, issued a statement in which she addressed the concerns of the federal watchdog agency.

In response to her speech, we invited Dr. James Kennedy, a 20-year veteran in clinical documentation integrity (CDI) consulting and a popular panelist, to share succinct advice on how a compliance plan can best prepare for OIG audits that are sure to come.   

Programming note: Invite your compliance teams to hear what promises to be the best four minutes applicable to this challenge, during the next live edition of Talk Ten Tuesdays.

The live broadcast will also feature these other segments:

• Coding Report: Laurie Johnson, senior healthcare consultant with Revenue Cycle Solutions, LLC, will report on coding colorectal cancer.
  
  
• SDoH Report: Tiffany Ferguson, a subject-matter expert on the social determinants of health (SDoH), will report on the news that’s happening at the intersection of coding and the SDoH.
  
  
• News Desk: Timothy Powell, CPA, will anchor the Talk Ten Tuesdays News Desk.
  
  
• TalkBack: Erica Remer, MD, founder and president of Erica Remer, MD, Inc. and Talk Ten Tuesdays co-host, will report on a subject that has caught her attention during her popular segment.