Sampling and extrapolation allow a claiming party to carry out detailed investigations on a sample of its claims. Provided that the sample is properly representative, the findings from the ...
There is little dispute that the False Claims Act (FCA) is among the most potent weapons for fighting fraud and government waste. In just this past fiscal year alone, the DOJ utilized the FCA to ...
As a result of a new rule published on February 1, 2023, at 88 Fed. Reg. 6643, Medicare Advantage (MA) organizations soon will be facing enhanced exposure from Risk Adjustment Data Validation (RADV) ...
On September 25, a federal district court vacated the Medicare Advantage risk adjustment and data validation (“RADV”) final rule that would have enabled the Centers for Medicare & Medicaid Services ...
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