Risk Adjustment Data Validation of Payments Made to Paramount Care, Inc., for Calendar Year 2007 (Contract Number H3653).

摘要

Paramount Care, Inc. (Paramount), is an MA organization owned by ProMedica Health. For calendar year (CY) 2007, Paramount had one contract with CMS, contract H3653, which we refer to as the contract. Under the contract, CMS paid Paramount approximately $134 million to administer health care plans for approximately 14,000 beneficiaries. Our objective was to determine whether the diagnoses that Paramount submitted to CMS for use in CMSs risk score calculations complied with Federal requirements.