2024 Managed Care Compliance Conference

105 False Claims Act Risk and the RADV Final Rule

  • 105 False Claims Act Risk and the RADV Final Rule

    Christine Worthen, Esq..

    Gabriel Imperato , Managing Partner , Nelson Mullins.

    2024-01-29

    • Discuss False Claims Act liability for health plans in connection with risk adjustment practices and reimbursement from federal health programs

    • The basis for "risk adjustment" liability and the compliance implications of the recent RADV rule and the development of health plan provider networks and correct coding initiatives

    • The anatomy of a False Claims Act case and managing the compliance risk for health plans, including liability for "risk adjustment" and claims to federal health programs

    • Review of the RADV Final Rule and best practices and strategies for compliance and alignment with business objectives

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About SCCE

The Society of Corporate Compliance and Ethics (SCCE) is a non-profit, member-based professional association. SCCE supports our members' work with education, news, and discussion forums. We are a community of leaders, defining and shaping the corporate compliance environment across a wide range of industries and geographic regions. In developing and maintaining effective ethics and compliance programs, our members strengthen and protect their companies.

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About HCCA

The Health Care Compliance Association (HCCA), is a 501(c)6 non-profit, member-based professional association. HCCA was established in 1996 and is headquartered in Minneapolis, MN. We provide training, certification, and other resources to over 10,000 members. Our members include compliance officers and staff from a wide range of organizations, including hospitals, research facilities, clinics and technology service providers.

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