National Law Review September 27, 2021
Over the past year, the federal government has taken concrete steps to fulfill its promise of a heightened commitment to investigating and enforcing health care fraud within the Medicare Advantage program (Medicare Part C). Health care providers that contract with Medicare Advantage Organizations (“MAOs”) and provide care to Medicare Advantage beneficiaries should take note, as they are not immune to the government’s enforcement efforts. Across two speeches in 2020, the Department of Justice (“DOJ”) identified Medicare Part C as a program of increasing focus and an important priority for False Claims Act (“FCA”) investigations and litigation. There are a growing number of recent decisions by DOJ to intervene in FCA cases alleging Medicare Advantage fraud, and a growing number of...
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