Monitor Mondays

Medicare Advantage “Schemes” in the DOJ Crosshairs

April 08, 2024 James Kennedy, MD | Knicole Emanuel, Esq. | David Glaser, Esq. | Ronald Hirsch, MD Season 13 Episode 585
Monitor Mondays
Medicare Advantage “Schemes” in the DOJ Crosshairs
Show Notes Chapter Markers

The recent $37 million settlement against Cigna regarding enhancing risk adjustment factor (RAF) scores —along with related litigation by the U.S. Department of Justice (DOJ)— highlight the aggressiveness of the federal government to crack down on entities for non-compliant billing practices.

During the next live edition of Monitor Mondays, Dr. James Kennedy will unpack the challenges entities have with this hot billing compliance issue. Dr. Kennedy will also recommend an approach that attempts to clarify what facilities and physicians can do to mitigate their risks.

Broadcast segments will also include these instantly recognizable features:

• Monday Rounds: Ronald Hirsch, MD, vice president of R1 RCM, will be making his Monday Rounds.

• The RAC Report: Healthcare attorney Knicole Emanuel, partner at the law firm of Nelson Mullins, will report the latest news about auditors.

• Risky Business: Healthcare attorney David Glaser, shareholder in the law offices of Fredrikson & Byron, will join the broadcast with his trademark segment.

Knicole Emanuel, Esq
David Glaser, Esq
James S. Kennedy, MD
Q&A With Ronald Hirsch, MD
Closing