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Medicare Advantage Organizations (MAOs) Healthcare Fraud

Mintz - Health Care Viewpoints

EnforceMintz — FCA Enforcement in Value-Based Care Arrangements Heated Up in 2024 and Likely to Remain a Priority in 2025

Value-based care (VBC) is a health care delivery model that has grown increasingly common in recent years. Perhaps unsurprisingly, this growth seems to have attracted the attention of government enforcement agencies...more

Fox Rothschild LLP

OIG Publishes Special Fraud Alert on Medicare Advantage Marketing Arrangements

Fox Rothschild LLP on

On December 11, the U.S. Department of Health and Human Services Office of Inspector General (“OIG”) published a Special Fraud Alert warning against suspect payment arrangements involving the Medicare Advantage (“MA”) program...more

Sheppard Mullin Richter & Hampton LLP

Special Fraud Alert: Suspect Payments in Marketing Arrangements Related to Medicare Advantage and Providers

Yesterday, the OIG released a Special Fraud Alert related to: (1) marketing arrangements between Medicare Advantage Organizations (“MAOs”) and health care professionals (“HCPs”), and (2) arrangements between HCPs and MA plan...more

Pietragallo Gordon Alfano Bosick & Raspanti,...

Kaiser Scores First-To-File Dismissal In Medicare Advantage Fraud Suit

Medicare Advantage Organizations have come under increased fire as their parent companies continue to acquire more healthcare practices across the country. Experts suggest that this vertical integration has led to inflated...more

American Conference Institute (ACI)

[Event] 11th Annual Advanced Forum on False Claims and Qui Tam Enforcement - January 23rd - 24th, New York, NY

Hosted by American Conference Institute, the 11th Annual Advanced Forum on False Claims and Qui Tam Enforcement returns for another exciting year for lively discussions on FCA enforcement including the ramifications of two...more

Bass, Berry & Sims PLC

11th Annual Healthcare Fraud & Abuse Review 2022

Bass, Berry & Sims PLC on

We are pleased to bring you our 11th annual Healthcare Fraud & Abuse Review. Our Review provides comprehensive coverage of the most significant civil and criminal enforcement issues facing healthcare providers. Each year, we...more

K&L Gates LLP

Health Care Triage: Medicare Advantage False Claims Act Developments

K&L Gates LLP on

In this episode, Stephen Bittinger and Nathan Huff discuss the growth of Medicare Part C (Medicare Advantage), new enforcements for Medicare Advantage Organization fraud, recent cases of False Claims Act liability, and key...more

Polsinelli

As DOJ Focuses on Medicare Advantage Reimbursement, So Should Health Care Providers

Polsinelli on

Over the past year, the federal government has taken concrete steps to fulfill its promise of a heightened commitment to investigating and enforcing health care fraud within the Medicare Advantage program (Medicare Part C). ...more

Bass, Berry & Sims PLC

Healthcare Fraud & Abuse Review 2020

Ensuring compliance with the False Claims Act has never been more important for healthcare providers. By March 2020, we saw healthcare professionals standing at the forefront of one of the greatest health crises in a...more

McDermott Will & Emery

[Webinar] 2019 Q4 Healthcare Enforcement Roundup - February 5th, 2:30 pm ET

McDermott Will & Emery on

The final quarter of 2019 brought forward new guidance and proposed rules with major implications for healthcare companies, enforcement developments in healthcare private equity investing and opioid litigation matters, among...more

Dorsey & Whitney LLP

Sutter Health LLC Pays $30 Million to Settle Alleged Overpayment of Medicare Advantage Funds, but Faces Similar Allegations in...

Dorsey & Whitney LLP on

On April 12, 2019, the U.S. Department of Justice announced Sutter Health LLC—along with its affiliates Sutter East Bay Medical Foundation, Sutter Pacific Medical Foundation, Sutter Gould Medical Foundation, and Sutter...more

The Volkov Law Group

DaVita Medical Pays $270 million to Settle False Claims Act Case

The Volkov Law Group on

I have a tendency to sound like a “broken record” (an odd phrase in these days of digital music). The government’s most powerful enforcement tool continues to be – drumroll please, the False Claims Act. ...more

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