Using the DRM MPD module, downloading Anna Pigeon from usanetwork.com works by cutting ads from the resulting file, but leads to out-of-sync audio after each ad break. The format/tool used (MP4 / MKV (FFmpeg) / MKV (MKVtoolnix)) does not appear to help.
I also notice that, for some breaks, if I manually seek to after the break in VLC, it will be in sync. However, if I let it play through a content->break->content sequence, it appears I see audio sync issues with a higher likelihood.