OIG to speak on marketing compliance at Medicare Marketing & Sales Summit

RISE is pleased to announce that Ben Wallfisch, senior counsel, Office of Counsel to the Inspector General, will discuss OIG’s approach to managed care oversight, enforcement, and compliance.

SAN JUAN, Puerto Rico, Jan. 16, 2025 /PRNewswire/ — RISE is pleased to announce that Ben Wallfisch, senior counsel, Office of Counsel to the Inspector General, will join the speaking faculty of the Medicare Marketing & Sales Summit, which will take place February 24-26 in San Juan, Puerto Rico.

In his role at OIG, Wallfisch drafts advisory opinions, regulations, and guidance documents, advises the Department of Justice on False Claims Act cases, and resolves provider self-disclosures.

His session, Guidance from the OIG: Medicare Advantage Marketing and Compliance, will take place on the last day of the conference, February 26 at 9:10 a.m.

Last month, OIG published a special fraud alert about marketing schemes that can mislead Medicare enrollees into choosing specific health plans or health care providers that may not meet their needs. The warning highlighted the fraud and abuse risks that can lead to improper payments and referrals between Medicare Advantage plans, health care professionals, and third-party marketers such as agents and brokers.

The alert is based on the OIG’s observation of an increase in abusive marketing practices in recent years. The alert focuses on two types of payments that have been the focus of settlements under the False Claims Act:

Payments from Medicare Advantage organizations to health care professionals or their staff relating to Medicare Advantage plan marketing and enrollment.

Payments from health care professionals (including payments from corporations that contract with or employ health care professionals and payments from management services organizations with which health care professionals’ contract) to agents, brokers, and others in exchange for referring Medicare enrollees to a particular health care professional.

Click here to learn more about the Medicare Marketing & Sales Summit, including preconference workshops, main conference sessions, speaker faculty, and how to register.

RISE is an organization created on the foundation of connecting health care professionals with guidance, continuing education opportunities, and each other. Our customers are established and emerging leaders that work for health plans, provider organizations, government agencies, health care technology brands, consulting and service vendors, and community-based organizations.

Our mission is to make meaningful impact on the health care industry by bringing together like-minded professionals for learning, networking, and innovating.

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SOURCE RISE