Medicare Advantage Enforcement: DOJ Advances New Theories Based on Retrospective Chart Reviews

Vitalii Vodolazskyi | Shutterstock
Over the past two months, DOJ has filed complaints-in-intervention in two FCA cases premised on allegedly fraudulent diagnosis codes submitted to CMS as a result of retrospective chart reviews. These cases demonstrate how DOJ has begun to explore new legal theories that articulate a narrower view on the legality of retrospective chart reviews designed to […]
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