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HHS OIG Work Plans February 2024 Update

HHS OIG Work Plans February 2024 Update

SunHawk Consulting, LLC is excited to announce the February 2024 updates to its HHS OIG reports. Every year HHS OIG Office of Audit Services and Office of Evaluation and Inspections conducts around 300 audits and evaluations. The OIG Work Plan outlines different...
The Evolution of the Standards – James Rose

The Evolution of the Standards – James Rose

In January 2024, the IIA released an update to the International Professional Practices Framework, including new Global Internal Audit Standards. In this session, you will gain insights into the new Standards from James Rose, a member of the International Internal...
“RISK” in Risk Adjustment

“RISK” in Risk Adjustment

In our previous article, we explained how Risk Adjustment is a “partnership” between the patient, the provider, the insurance plan (Plan), and the governmental entity. So, which partner in this process holds the “risk”? Governmental Entity: The governmental entity has...
Risk Adjustment Is a Partnership???

Risk Adjustment Is a Partnership???

Under the risk adjustment (RA) model, reimbursements to the insurance companies (Plans) are based on the member’s level of severity of illness rather than the number and types of interventions the member receives throughout the year. This reimbursement model is based...
Are You Ready For The 2024 Risk Adjustment Model?

Are You Ready For The 2024 Risk Adjustment Model?

This article, as part of the SunHawk Consulting team’s Medical Risk Adjustment compliance as well as statistical sampling & coding audit services, gives a high level overview of some upcoming changes for 2024 in the CMS Risk Adjustment model, V28. The CMS-HCC Risk...