Benjamin Poehling a former official with UnitedHealth filed a whistleblower lawsuit saying that Medicare Advantage made tens of billions of dollars each year in improper payments to insurers. The suit alleges that the UnitedHealth created ways to make patients look sicker than they were by scouring their health records and manipulating the...
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Category: Medicare Fraud
Carecore National LLC a benefits management agrees to pay $54 million to settle whistleblower suit for Medicare fraud
Carecore National LLC, part of evicore a benefits management company has agreed to pay $54 million to settle a False Claims Act whistleblower lawsuit for improperly approving prior authorization requests for hundreds of thousands of diagnostic procedures paid for with Medicare and Medicaid funds. Acting U.S. Attorney Joon H. Kim said: "Benefit management companies...
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Podiatrist charged with $13.9 Million in Medicare fraud over unnecessary foot surgeries
Lawrence Young, D.P.M a Detroit podiatrist has been charged with participating in a $13.9 million healthcare fraud scheme in which he is accused of performing unnecessary foot surgeries on patients.
Prosecutors unsealed an indictment Thursday revealing that , Young has been charged with six counts of healthcare fraud, says the U.S. Attorney's Office for the...
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Justice Department joins billion dollar lawsuit against UnitedHealth Group for fraud in Medicare Advantage
The Department of Justice joined whistleblower’s lawsuit against UnitedHealth Group accused of fraud in its popular Medicare Advantage health plans. The suit, first brought by whistleblower James Swoben in 2009, on Friday in federal court in Los Angeles accused the insurer of “gaming” the Medicare Advantage payment system by “making patients look sicker...
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Aetna, Cigna subsidiary Bravo Health, Health Net and Humana under DOJ investigation for Medicare Fraud
The U.S. Department of Justice is investigating four major insurance companies four insurance companies, alleging that they submitted false Medicare claims to increase risk adjustment payments and kept overpayments from CMS.
They include, Aetna, Cigna subsidiary Bravo Health, Woodland Hills, Calif.-based Health Net and Louisville, Ky.-based Humana, according to papers filed last week in a...
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Why don’t we just change the name from Obama Care to Interim Care?
After the Congressional Budget Office released its assessment of the American Health Care Act predicting an increase of 24 million Americans without health insurance by 2026, there was an interesting response from Senate Republicans. They suggested certain changes to the bill which, they said, would increase the chances of it being approved by the...
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FBI Agents questioning Department of Justice Lawyers on possible leak of whistleblower lawsuit to former DOJ attorney Wertkin
Last week, it was revealed that Prosecutors say that a former government lawyer named Jeffrey Wertkin tried to sell a whistleblower's sealed, confidential lawsuit against a Silicon Valley company, for $310,000. He wore a wig to try to disguise him but the man Wertkin was selling to was actually an FBI undercover agent. Wertkin,...
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DOJ says UnitedHealth Group defrauded Medicare through advantage plans
According to a recent federal court filing by the Department of Justice, UnitedHealth Group and affiliated health plans have been defrauding the Medicare program by collecting millions of dollars by claiming patients were sicker than they really were.
The suit says UnitedHealth has inflated its plan members’ risk scores since...
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Jeff Newman Law Announces a $12.7 Million Settlement in Whistleblower Medicare Fraud Case Against MedStar Ambulance of Massachusetts
Former Employee Claimed Company Falsified Bills for Ambulance Services to Fraudulently Qualify for Higher Medicare Reimbursements in Violation of the False Claims Act
BOSTON – January 13, 2017 – Jeffrey A. Newman P.C., a law firm dedicated to representing whistleblowers nationwide, today announced that MedStar Ambulance, Inc. and its related...
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Forest Labs and Forest Pharma pays $38 million to end kickback Medicare fraud probe
Forest Laboratories LLC, located in New York, New York, and its subsidiary, Forest Pharmaceuticals Inc., are paying $38 million to settle a government probe that they violated the False Claims Act by paying kickbacks to get physicians to prescribe the drugs Bystolic®, Savella®, and Namenda® said the Departmet of Justice,
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