Medicare Advantage Risk Adjustment: Legal Issues for MA Plans, Providers, and Vendors

June 25, 2020

The webinar will address legal issues for MA plans, providers, and vendors from the Medicare Advantage risk adjustment payment structure.  We will provide an overview of recent case law affecting legal obligations and best practices for MA plans, providers, and vendors.  This case law, which is primarily under the False Claims Act, creates potential liability for MA plans and their contracted providers and vendors who submit or facilitate the submission of diagnosis codes.  We will discuss best practices and compliance considerations for MA plans, providers, and vendors as they navigate this uncertain regulatory and legal environment.  

We will also provide an update on current risk adjustment CMS guidance and address open policy questions where we expect the agency to provide future guidance.


Edward Baker, Constantine Cannon LLP

Brandon J Moss, Wiley Rein LLP

Heidi Wendel, Law Office of Heidi A. Wendel PLLC

On-Demand Webinars are not included in AHLA Premium or other membership levels.

AHLA does not currently offer Continuing Education Credit for On-Demand Webinars. Contact your state to determine whether self-study credit is available.