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

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