Elizabeth Lippincott will Co-Chair and speak at American Conference Institute’s (ACI) Legal, Regulatory and Compliance Summit on Medicare Advantage

Published On: September, 2022
Elizabeth Lippincott | Founding Member | Strategic Health Law

October 12- 13, 2022
Nashville, Tennessee

Elizabeth Lippincott will co-chair and speak at ACI’s Legal, Regulatory and Compliance Summit on Medicare Advantage from October 12-13, 2022, in Nashville, Tennessee.  Elizabeth’s co-chair is Karen Lam of Kaiser Permanente.  Elizabeth will be presenting alongside Teresa A. Mason of Epstein Becker Green and Julie Nielsen of Berkeley Research Group discussing Risk Adjustment: Forecasting the Future of Enforcement and the Implications for the Compliance and Legal Landscape.

The presentation will cover:

  • Why CMS is not a plan’s biggest worry
  • Analysis of oversight channels
    • CMS RADV audits
    • OIG Targeted and RADV-like audits
    • Whistleblower FCA litigation
    • DOJ perspective on risk adjustment as revealed in FCA litigation
  • Insights on the relevance of actuarial equivalence and current applications in law
    • Overpayment rule
  • Examining how plans calculate bid rates and risk score projections
  • Forecasting potential outcomes for the CMS’ proposed rule and the implications for MAOs
    • Identifying calculation modifications and how to align internal processes to ensure compliance
    • how does it ultimately impact plans who are selected for RADV audit
  • Developing compliance oversight of risk adjustment in the absence of cohesive guidance
  • Determining what immediate corrective actions can be taken when FWA is detected

To learn more about Elizabeth Lippincott, please view her bio.

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