Media Mentions6.3.25
Criminal Enforcement Challenges in Medicare Advantage Fraud Cases
Barnes & Thornburg partner Tony Burba discusses key obstacles to prosecution in Bloomberg Law
Barnes & Thornburg partner Anthony “Tony” Burba, a former federal prosecutor and member of the firm’s White Collar and Investigations practice, was featured in Bloomberg Law’s recent article examining the complexities of criminal enforcement in Medicare Advantage fraud cases.
In the piece, Burba explained that Medicare Advantage fraud cases — often involving alleged “upcoding” — are especially tough to prosecute due to the complexity of the risk-adjusted payment system and steep DOJ learning curves. He noted that high turnover and diffuse decision-making within large organizations further slow efforts to identify and charge responsible individuals.
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