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OIG Report: Anthem Coding Errors Resulted in CMS Overpayments of $3.47 Million
Office of Inspector General [OIG], U.S. Department of Health and Human Services [HHS] May 26, 2021 "For 123 of the 203 enrollee-years, the diagnosis codes that Anthem submitted to CMS were not supported in the medical records and resulted in $354,016 of net overpayments for the 203 enrollee-years.... On the basis of our sample results, we estimated that Anthem received at least $3.47 million of net overpayments for these high-risk diagnosis codes in 2015 and 2016." |
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