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
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