Foley Partner Michael Matthews, chair of the Tampa Litigation Department and as chair of the firm’s False Claims Act Litigation group, will be speaking at the Medicare Risk Adjustment Revenue Management conference on February 23, 2018. His presentation is titled, “What You Need to Know About Recent Risk Adjustment Fraud Litigation.”
Risk adjustment fraud litigation has exploded in the last several years. Department of Justice lawyers and whistleblowers are bringing False Claims Act and other lawsuits that are reshaping the face of risk adjustment, attacking Medicare Advantage Organizations’ and other entities’ filter logic, chart review processes, RAPS submissions, fraud detection and compliance efforts, and multiple other aspects of their processes. This session will include a discussion of the pending government’s False Claims Act cases against UnitedHealth and UnitedHealth’s related suit against the Department of Health and Human Services challenging its overpayment refund rules, among other pending and recent risk adjustment fraud lawsuits, as well as takeaways and lessons learned from such litigation.
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