Questioner cites HHS OIG findings as hearing probes whether Medicare Advantage plans rely on documentation to set care levels An unidentified questioner at a hearing said Medicare Advantage should improve care, not 'incentivize gaming the system,' and asked whether plans ever decide claim levels without documentation; the questioner cited HHS OIG reports that some diagnoses were added via in‑home assessments and chart reviews.

A recent hearing raises serious questions about whether Medicare Advantage plans are making care decisions without proper documentation, potentially putting seniors at risk.

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