Edward A. Baker, Of Counsel, Constantine Cannon LLP. Nicholas N. Paul, Supervising Deputy Attorney General, Office of the California Attorney General.
January 27, 2020
Medicare Advantage plans, Medicaid MCOs, and their partners are increasingly attractive targets for FCA whistleblower lawsuits
The U.S. DOJ and State MFCUs face many challenges, but are gaining traction against managed care fraud, including risk adjustment and network compliance fraud
Having a written compliance plan is not enough; MCOs must develop and implement systems that steer clear of FCA liability
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