Medicare Advantage “Schemes” in the DOJ Crosshairs

Monitor Mondays

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.

अध्यायों

1. Medicare Advantage “Schemes” in the DOJ Crosshairs (00:00:00)

2. Ronald Hirsch, MD (00:01:24)

3. Knicole Emanuel, Esq (00:06:45)

4. RACmontior Commercial (00:12:20)

5. David Glaser, Esq (00:13:33)

6. RACmontior Commercial (00:18:15)

7. James S. Kennedy, MD (00:19:01)

8. Q&A With Ronald Hirsch, MD (00:26:44)

9. Closing (00:30:22)