Thomas Hill

Thomas Hill

Pillsbury Winthrop Shaw Pittman LLP

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CMS Proposes Expansion of RAC Program to Medicare Part C – All Medicare Advantage Contracts to Become Target of RADV Audits

On December 22, 2015, the Centers for Medicare & Medicaid Services (CMS) released a request for information (RFI) and a proposed statement of work (SOW) seeking industry feedback on the expansion of the recovery audit...more

2/2/2016  /  Audits , Centers for Medicare & Medicaid Services (CMS) , Medicare Advantage , Medicare Part C , Overpayment , Recovery Audit Contractors (RACs) , Underpayment

Bipartisan Spotlight on Medicare Advantage Risk Adjustment Fraud Likely to Spur Audits

Potential fraud and abuse in the Medicare Advantage Program (“MA Program”) has become the focus of two senior-ranking Senators on each side of the aisle—Chuck Grassley (R-Iowa) and Claire McCaskill (D-Mo.)—and this attention...more

6/19/2015  /  Audits , Centers for Medicare & Medicaid Services (CMS) , Department of Justice (DOJ) , Fraud and Abuse , Healthcare , Legislative Agendas , Medicare , Medicare Advantage , Strategic Enforcement Plan , Whistleblowers
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