In an indictment announced on October 26, 2023 in Miami, the U.S. Department of Justice, Criminal Division’s Fraud Section, working with the FBI and HHS-OIG, brought what may be only the second federal criminal charges directly related to the Medicare Advantage (Medicare Part C) risk adjustment payment methodology. DOJ enforcement in the Medicare Advantage risk adjustment space overwhelmingly has proceeded civilly under the False Claims Act. Although the allegations suggest conduct far more troubling than prior civil cases under risk adjustment, these criminal charges ...
Blog Editors
Recent Updates
- The 340B Reimbursement Battle: What Hospitals and Insurers Need to Know
- A Ticking Time Bomb—Universal Injunctive Relief at Risk - SCOTUS Today
- CFPB’s Recent Rule Eliminates Medical Debt from Credit Reports
- Justices Rebuke Appeals Court for Overlooking High Court Precedent on Unduly Prejudicial Evidence - SCOTUS Today
- TikTok, the Clock Won’t Stop, and Cases Involving Court Jurisdiction Narrowly Focused - SCOTUS Today