602 – The Risks of Risk Adjustment Reviews: Enforcement Trends and Litigation Involving Medicare Advantage Risk Adjustment Practices

Learning Objectives:

• In the last year, DOJ has proclaimed Medicare Advantage to be a prime enforcement target. 
• While DOJ has suffered setbacks, they are primed to attack Medicare Advantage providers’ practices with respect to auditing or reviewing risk adjustment scoring — both civilly and criminally. 
• This panel will discuss recent enforcement trends, where courts are lining up on interpreting key regulations, and what all this means for Medicare Advantage providers looking to navigate this high-stakes and ever-changing landscape.

Speaker:

• Rachel Alexander, Partner, Wiley