HHS OIG Audit of Gateway Health Plan Medicare Advantage Compliance

Mon, 16 Mar 2026 15:17:34 +0000
Healthcare

The HHS Office of Inspector General (OIG) audited Gateway Health Plan, Inc.'s submission of diagnosis codes to CMS for Medicare Advantage risk adjustment. The audit found that most sampled diagnosis codes were not supported by medical records, leading to an estimated $4.3 million in net overpayments for 2018 and 2019.