Jackie Selby, Member of the Firm, and Gregory R. Mitchell, Associate, in the Health Care and Life Sciences practice, in the firm’s New York office, co-authored an article in Pratt’s Government Contracting Law Report, titled “New Audits and Penalties on Medicaid Plans and Providers Related to Encounter Data in Value-Based Payment Models.”

Following is an excerpt (see below to download the full version in PDF format):

With the growing prevalence of value-based payments, especially in Medicaid programs, the focus on encounter data is growing. The federal government and many states are currently tying the receipt of payments to the timely submission of complete and accurate encounter data, and are requiring states to audit Medicaid managed care plans’ encounter data to ensure that such data is timely and accurate. The authors of this article discuss the trend and suggest that plans and providers ensure that their encounter data collection and submission processes are robust, accurate, and compliant with federal and state laws and regulations.

Resources

Jump to Page

Privacy Preference Center

When you visit any website, it may store or retrieve information on your browser, mostly in the form of cookies. This information might be about you, your preferences or your device and is mostly used to make the site work as you expect it to. The information does not usually directly identify you, but it can give you a more personalized web experience. Because we respect your right to privacy, you can choose not to allow some types of cookies. Click on the different category headings to find out more and change our default settings. However, blocking some types of cookies may impact your experience of the site and the services we are able to offer.

Strictly Necessary Cookies

These cookies are necessary for the website to function and cannot be switched off in our systems. They are usually only set in response to actions made by you which amount to a request for services, such as setting your privacy preferences, logging in or filling in forms. You can set your browser to block or alert you about these cookies, but some parts of the site will not then work. These cookies do not store any personally identifiable information.

Performance Cookies

These cookies allow us to count visits and traffic sources so we can measure and improve the performance of our site. They help us to know which pages are the most and least popular and see how visitors move around the site. All information these cookies collect is aggregated and therefore anonymous. If you do not allow these cookies we will not know when you have visited our site, and will not be able to monitor its performance.