Risk Adjustment

We are pleased to have the opportunity to connect with you and provide a few resources we believe you will find informative. 

Our Medicare Advantage Risk Adjustment team:

  • Provides risk adjustment legal services to a variety of risk adjustment entities including health plans, downstream vendors and providers
  • Offers compliance counseling regarding risk adjustment operational issues
  • Works with clients and government agencies in the identification of and disclosure of overpayments
  • Counsels risk adjustment clients in connection with internal and government led investigation regarding coding accuracy and practices, vendor relationships, downstream compensation, adequacy of compliance and retractions/deletions under health risk adjustment coding
  • Consults with plans undergoing Risk Adjustment Data Validation (RADV) audits and assists with the RADV appeals process

Complimentary Webinar, April 26, 2018:

Fraud and Abuse Enforcement in the Risk Adjustment Industry: The Shifting State of Play

Please join us for a webinar that focuses on fraud and abuse enforcement in the risk adjustment industry.

Our speakers will provide an overview of enforcement matters and emerging trends to assist plans, providers, and vendors in navigating the changing risk-adjustment landscape.

The Centers for Medicare & Medicaid Services has provided limited guidance in key areas, and, as a result, case law and government settlements could set the stage for future operational precedent for years to come.

Click here to register for this complimentary webinar.

Have a question? Please email Adam Govia at agovia@ebglaw.com.