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...more
11/2/2023
/ Criminal Prosecution ,
Department of Justice (DOJ) ,
Enforcement Actions ,
Fee-for-Service ,
Health Insurance ,
Healthcare ,
Healthcare Fraud ,
Indictments ,
Medicare Advantage ,
Medicare Part C ,
Risk Adjustment Formula
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)...more