What Does Fraud in the Medicare Advantage Space Mean for the Reverse False Claims Provision?
As the percentage of Medicare and Medicaid beneficiaries in managed care increases, there is a risk that fraudsters will misrepresent Medical Loss Ratios to the government.
A Tradition of Fraud Persists in New Types of Medicare Delivery Models
Unscrupulous medical providers, hospitals, and drug manufacturers, can and do defraud Medicare Advantage plans in the same ways they defraud “traditional” Medicare.