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
- DOJ’s Antitrust Division Launches New Task Force to Target Health Care Monopolies and Collusion
- Twice Again, Jurisdictional Timing Matters; Battle Among Originalists Leaves Consumer Financial Protection Board Standing - SCOTUS Today
- Litigating Nutrition: Class Action Battles Over Dietary Supplements – Speaking of Litigation Video Podcast
- Matters of Time - SCOTUS Today
- The Department of Justice’s Criminal Division Launches a Pilot Program on Voluntary Self-Disclosures for Individuals