"This has to be a two-way street from...

 ...a compliance perspective. There are plenty of clear guidelines that are issued by the government, talking about the expectation that you’re going to be looking at your data, assessing that data and if you’re finding anomalies or issues with the data, you’re going to correct it."

—Health care compliance expert John Kelly, former assistant chief for health care fraud at the DOJ and managing partner of Bass, Berry & Sims’ Washington, D.C. office, spoke with AIS’s Radar on Medicare Advantage about the government’s increased focus on MA risk adjustment when investigating fraud.

 

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