Alerts1.23.23

False Claims Act Case May Proceed Against Medicare Advantage Organization, Subsidiaries

Medical Devices

A federal court recently interpreted the International Classification of Diseases (ICD) Guidelines to require that diagnoses added through addenda must have required or affected patient care or management at the encounter

A decision earlier this month allowing a case to proceed regarding alleged fraud by a Medicare Advantage Organization (MAO) and its subsidiaries signals the continued scrutiny of certain risk-adjustment practices in the healthcare industry. 

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