In Bloomberg Law, Health Care Team Examines Medicare Advantage Enforcement Trends

In an article published by Bloomberg Law, litigation & enforcement partners Laura Hoey and Andrew O’Connor and health care associate Samuel Perrone examined the key enforcement trends that Medicare Advantage Organizations, providers, and vendors should consider in 2024, including:

• the possible scrutiny of third-party vendors with a nexus to billing and coding
• potential FCA liability for private equity investors in Medicare Advantage plans
• investigation of AI utilization in Medicare Advantage
• value of self-disclosure
• third-party marketing organization oversight
• extrapolation
• the OIG role in Medicare Advantage plan compliance oversight

Litigation & enforcement counsel Renai Rodney and associates Dominique Rioux, John King, and Shanzeh Daudi also contributed to the article.