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Risk Adjustment Fraud

This archive displays posts tagged as relevant to risk adjustment fraud in managed care programs You may also be interested in our pages:

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September 24, 2018

Mary Inman appeared on RAC Monitor's "Monitor Monday" podcast discussing the United Health Group case.  Click here to hear the podcast.

Constantine Cannon Partner Jessica Moore on Court’s Decision in Medicare Advantage Case

Posted  07/23/18
Becker’s Hospital Review published Four Key Takeaways From 9th Circuit’s Resurrection of the Silingo Medicare Advantage Case, written by Constantine Cannon partner Jessica T. Moore. In the article, Ms. Moore analyzes the Ninth Circuit’s July, 2018, ruling in U.S. ex rel. Silingo v. WellPoint, Inc., a case brought by a whistleblower under the False Claims Act alleging risk adjustment fraud in Medicare’s Part C...

4 Key takeaways from 9th Circuit’s Resurrection of the Silingo Medicare Advantage Case

Posted  07/20/18
CC Attorney Jessica T. Moore
Whistleblower attorney Jessica Moore published in Becker's Hospital Review (July 20, 2018).  Click here to read the article.

Medicare Parts C and D: A look at cases and recent developments surrounding Medicare Parts C and D and risk adjustment fraud

Posted  11/2/17
CC Attorney Mary Inman
Moderator; 17th Annual Taxpayers Against Fraud Education Conference, Washington D.C. (November 2, 2017).

Moderator: "Medicare Parts C and D: A look at cases and recent developments surrounding Medicare Parts C and D and risk adjustment fraud"

Posted  11/2/17
CC Attorney Mary Inman
17th Annual Taxpayers Against Fraud Education Conference (November 2, 2017) By Mary Inman

Aftershocks of the Feds' Big Bust: Lessons Learned

Posted  07/18/17
By the C|C Whistleblower Lawyer Team Listen to RAC Monitor's broadcast program, "Aftershocks of the Feds' Big Bust: Lessons Learned," featuring Constantine Cannon Partner, Mary Inman. Ms. Inman discusses the DOJ's recent Health Care Fraud Takedown and the prosecution of medical professionals involved in opioid-related crimes as a DOJ health care enforcement priority (at 21:30 of the broadcast). Click here for more.

May 30, 2017

Florida-based managed care service provider Freedom Health Inc. agreed to pay roughly $32 million to settle charges it violated the False Claims Act by engaging in illegal schemes to maximize its Medicare Advantage plan payments from the government.  The allegations originated in a whistleblower lawsuit filed under the qui tam provisions of the False Claims Act by former Freedom Health employee and Constantine Cannon client Darren D. Sewell.  He will receive a yet-to-be-determine whistleblower award from the proceeds of the government's recovery.  Whistleblower Insider

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