- Posts by Chloe T. Hillard
AssociateChloe Hillard helps health care organizations develop the legal solutions they need in today’s health care space.
Chloe assists hospitals, physician practices, and other health care providers with a broad range of legal ...
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 ...
On February 1, 2023, the Centers for Medicare & Medicaid Services (CMS) published a final rule outlining its audit methodology and related policies for its Medicare Advantage (MA) Risk Adjustment Data Validation (RADV) program. The final rule codifies long-awaited regulations first proposed by CMS in 2018.
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Recent Updates
- Podcast: 42 CFR Part 2 Final Rule: What’s Changing and What Do You Need to Know? – Diagnosing Health Care
- Congress Creates Yet Another Cliff for Medicare Telehealth Extensions (and We’re Running Out of Metaphors)
- OIRA Memo on Agency Deregulation: Implications for Health Care
- Outside Counsel’s Internal Investigations—Including Those Relating to Health Care—Are Privileged and Protected from Disclosure
- Podcast: Current Tailwinds in Women’s Health - What Do They Mean for Your Business? – Diagnosing Health Care