[Webinar] Adjusting the Risk for Medicare Advantage: Recent Enforcement Trends and Litigation Involving Medicare Advantage Risk Adjustment Practices

June 22nd, 12:00 pm - 1:00 pm ET
Wiley Rein LLP
June 22nd, 2021
12:00 PM - 1:00 PM ET

The Department of Justice (DOJ) continues to concentrate on risk adjustment programs of payers with Medicare Advantage Organizations (MAO) as a prime enforcement target. One particular area of focus, both civilly and criminally, for the DOJ has been MAO’s practices with respect to the capture of diagnoses, auditing, and reporting of risk adjustment data. Please join our speakers from Wiley and KPMG who will provide an overview of the high-stakes and ever-changing risk adjustment regulatory, enforcement, and litigation landscape for MAOs looking to navigate this high risk and evolving landscape.

This webinar will cover:

  • An overview of the risk adjustment methodology and regulatory environment;
  • A survey of the risk adjustment enforcement and litigation landscape and;
  • Risk adjustment documentation, diagnosis abstraction, coding pitfalls, and best practices.


Rachel A. Alexander
Partner, Wiley

Brandon J. Moss
Partner, Wiley


Jaime Pego
Managing Director, KPMG


Marissa Fremont
Director, KPMG


Lisa Uricks
Senior Specialist, KPMG



More Info

  • This event is complimentary but advance registration is required. Can’t make the date? Register and we’ll send you the slides and recording after the webinar.
  • CLE credit is available for this webinar. Wiley is an accredited or approved CLE provider in the following states: California, New York, and Texas. Wiley will apply for credit in the following states: Colorado, Georgia, Idaho, Illinois, Indiana, Kentucky, Mississippi, Oklahoma, Oregon, Pennsylvania, Rhode Island, Virginia, Vermont, Washington, and Wisconsin. The list of states Wiley is not currently able to offer CLE credit includes Alabama, Delaware, Indiana, Kansas, Louisiana, Minnesota, Missouri, Nebraska, Nevada, North Carolina, Ohio, South Carolina, Tennessee, Utah, West Virginia, and Wyoming. In these instances, Wiley can offer a certificate of attendance. For those seeking CLE credit, please complete the program evaluation at the end of the program. Wiley will be unable to issue CLE certificates until we have received all required documentation.
  • For New York CLE purposes, this program is appropriate for both newly admitted and experienced attorneys. Note that newly admitted New York attorneys (attorneys admitted two years or less) may earn CLE credit in certain categories of credit through completion of courses permissible formats, as explained here.
  • Webinar instructions and materials will be distributed prior to the webinar. For more information, please email Drew Altenburg at aaltenburg@kpmg.com; for questions about CLE, please contact Danielle Hood at dhood@wiley.law.

DISCLAIMER: Because of the generality of this update, the information provided herein may not be applicable in all situations and should not be acted upon without specific legal advice based on particular situations.

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