Bass, Berry & Sims attorney Lindsey Fetzer provided insight for an article in STAT News about the Centers for Medicare and Medicaid Services (CMS) fining Medicare Advantage plans for overcharging members. While the fine amounts may be small, there are other risks associated with the penalties.

Besides the reputational risk, there is the potential that workers at the MA plans could report the errors to federal prosecutors. As Lindsey points out, “If you’re getting [civil monetary penalties], you got all these people in the organization that know it. And you also know of other corrective action requirements from audits that are going to happen, and it incentivizes whistleblower behavior.”

The full article, “Feds Fine Medicare Advantage Plans for Overcharging Their Members,” was published by STAT News on August 28 and is available online (subscription required).