• Posts by Chloe T. Hillard
    Associate
    | 202-861-1861

    Chloe Hillard helps health care organizations develop the legal solutions they need in today’s health care space.

    Chloe assists hospitals, physician practices, and other health care providers with a broad range of legal ...

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Rare DOJ Criminal Indictment Related to Medicare Advantage Risk Adjustment
Categories: Health Care, White Collar
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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 directly related to the Medicare Advantage (Medicare Part C) risk adjustment payment methodology.  DOJ enforcement in the Medicare Advantage risk adjustment space overwhelmingly has proceeded civilly under the False Claims Act. Although the allegations suggest conduct far more troubling than prior civil cases under risk adjustment, these criminal charges ...

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