Recent activities of the Department of Justice (“DOJ”) and Qui Tam whistleblowers reveal that Medicare Advantage Plans remain at the forefront of investigations for violations of the federal False Claim Act (“FCA”) for...more
6/12/2017
/ Centers for Medicare & Medicaid Services (CMS) ,
Department of Justice (DOJ) ,
False Claims Act (FCA) ,
Florida ,
Health Insurance ,
Healthcare Fraud ,
Medicare ,
Medicare Advantage ,
Personal Liability ,
Qui Tam ,
Risk Adjustment Formula
As reported in earlier blogs, the federal Department of Justice (DOJ) has been actively looking into potential abuses by Medicare Advantage (MA) Organizations as to allegedly improper risk adjustment claims submissions and...more
5/26/2017
/ Aetna ,
Centers for Medicare & Medicaid Services (CMS) ,
CIGNA ,
Department of Justice (DOJ) ,
False Claims Act (FCA) ,
Government Investigations ,
Health Insurance ,
Health Net ,
Healthcare Fraud ,
Humana ,
Medicare Advantage ,
Qui Tam ,
Risk Adjustment Formula ,
UnitedHealth
In our prior blog post, we reported that, at the request of the federal Department of Justice, the FCA qui tam whistleblower lawsuit in the case of United States ex rel Benjamin Poehling v. United HealthGroup, Inc., et. al....more
WHO IS AT RISK -
The federal government has indicated that it is still investigating, and could ultimately join a false claims whistleblower qui tam action against Aetna, Inc., Humana, Inc., Cigna, Inc. (through its Bravo...more