| Text of Recommendation | We recommend that Aetna, Inc. determine, for the remaining 159 enrollee-years in the potentially mis-keyed diagnosis code high-risk group not reviewed as part of this audit, whether the medical records in each case support the diagnosis for the unrelated condition and refund any resulting overpayments to the Federal Government. |
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| Recommendation Number | 24-A-01-001.02 |
| Recommendation Status | Open |
| Significant Recommendation | No |
| Recommendation Questioned Costs | $0 |
| Recommendation Funds for Better Use | $0 |
| Submitting OIG | |
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| Linked Report |