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
- Utah Law Aims to Regulate AI Mental Health Chatbots
- National Science Foundation (NSF) Imposes 15% Indirect Cost Rate Cap: What to Know
- New DOJ White Collar Priorities Focus on Health Care Fraud
- Federal Regulators Announce Non-Enforcement of the 2024 Rule for Mental Health Parity
- Will Colorado’s Historic AI Law Go Live in 2026? Its Fate Hangs in the Balance in 2025