Lexology January 16, 2025
As government scrutiny and enforcement targeting the Medicare Advantage (Medicare Part C) program continued in 2024, the industry’s response to agency actions escalated. Last year also resulted in the first sizable Part D False Claims Act settlement. Year over year, as the number of enrollees in Medicare Advantage plans and Part D plans has steadily increased, the total federal spending on Medicare Advantage and Part D has likewise risen and the spotlight on these programs and those who participate in them has intensified.
As seen in years past, the Department of Justice (DOJ) as well as the two agencies that regulate Medicare Advantage Organizations (MAOs) and Part D plan sponsors (PDP Sponsors), the Centers for Medicare & Medicaid Services (CMS),...