Retrieving Billions in Overpayments by CMS

Retrieving Billions in Overpayments by CMS

Amid swirling accusations that Medicare Advantage Organizations (MAOs) are overbilling the U.S. government and calls for better oversight, the Centers for Medicare & Medicaid Services announced in early February that it would investigate overbilling by those plans. They expect to recoup 4.7 billion dollars through this program.
This article focuses on the relatively young technologies that enable CMS to uncover overbillings, whether they be errors or fraud. The article is based on an interview with Kel Pults, chief clinical officer and vice president of MediQuant. A future article will explain how Medicare Advantage plans are trying to improving data collection and reporting,…

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Medication risk analysis company MDI Health raises $20M

Medication risk analysis company MDI Health raises $20M

Healthcare analytics company MDI Health scored $20 million in Series A funding, bringing the company’s total funding to $26 million.Intel Capital led the round, with participation from Maverick Ventures Israel, alongside existing investors Fresh.Fund, Arc Impact, Hanaco Ventures, Jumpspeed Ventures, former Optum senior vice president Richard Montwill, Welltech Ventures and Basad Ventures.
Yoni Greifman, Intel Capital’s investment director, will join MDI’s board of directors.
WHAT IT DOES
Israel-based MDI offers an AI-enabled tool that provides medication risk analysis based on a patient’s medical records with the aim of preventing adverse drug reactions.
The funds will help the company scale its U.S. and Israeli research and…

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