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 ...
- What Does the Upcoming Amendment to Federal Rule of Evidence 702 Mean for the Admission of Expert Testimony?
- Rare DOJ Criminal Indictment Related to Medicare Advantage Risk Adjustment
- What to Do When Your Distribution Checks Stop Arriving
- The Validity of More Than a Decade’s Worth of Federal Regulations Are at Stake as the U.S. Supreme Court Decides the Constitutionality of the Consumer Financial Protection Bureau’s Funding Structure
- What to Know About the New DOJ Mergers & Acquisitions (M&A) Safe Harbor Policy for Voluntary Self-Disclosures Made in Conjunction with Misconduct: Questions and Answers