Jill Abrams

At HHS, Jill served as senior attorney in the Office of the General Counsel’s Centers for Medicare and Medicaid Services (CMS) Division, where she advised on fraud and abuse, enforcement, and other policy issues, working closely with the U.S. Department of Justice (DOJ) and the HHS Office of the Inspector General. Her extensive experience in this role and knowledge of agency personnel allows her to provide valuable support to managed care clients on regulatory and enforcement matters as well as appeals.

Jill’s experience includes advising on:

• Government audits, including risk adjustment data validation (RADV) audits
• Internal investigations
• Disclosures to the government
• Developing and implementing compliance plans
• New and evolving regulations and guidance
• Disputes with downstream service providers to MA plans
• Medicare marketing rules
• Compliance and enforcement actions, including sanctions, CMPs, and terminations
• Administrative appeals processes relating to MA and Part D
• General regulatory counseling regarding the prescription drug price negotiation program, particularly compliance and enforcement involving drug manufacturers
• False Claims Act (FCA) cases involving MA and Part D