Congressional committee pegs Medicare Advantage overpayments at $7 billion annually, rising

The Congressional Joint Economic Committee released a report stating Medicare Advantage overpayments now amount to $7 billion per year and are increasing. The analysis ties the overpayments to upcoding practices and risk-score inflation, raising the potential for future CMS program integrity audits and clawbacks. Billing managers should monitor MA encounter data submissions for compliance, as this report adds political pressure for CMS to intensify its Risk Adjustment Data Validation (RADV) audit program and recoup funds.