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From this week's edition

High CMS HHS

The Villages Health settles $541.5M False Claims Act case over Medicare Advantage diagnosis coding

Settlement resolves allegations that Florida-based primary care network inflated Medicare Advantage risk scores through improper diagnosis submission. The Villages Health System has agreed to pay $541.5 million to settle allegations that it submitted false diagnosis codes to the government to...

High Other

NCQA Announces HEDIS Transitions of Care Measure Shifting to Fully Digital ECDS Reporting

The move from hybrid to electronic clinical data systems reporting aims to streamline data exchange and align with industry digital quality measurement trends. NCQA is transitioning the HEDIS® Transitions of Care (TRC) measure from its current hybrid reporting methodology to a fully electronic...

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