Packerland
Guru
- 518
Just another reason to for CMS to wake up
[EXTERNAL LINK] - Nurse Practitioner Sentenced for $192M Medicare Fraud Scheme
[EXTERNAL LINK] - Nurse Practitioner Sentenced for $192M Medicare Fraud Scheme
$192,000,000
- Thread starter Packerland
- Start date
HealthCare Partners Holdings LLC, doing business as DaVita Medical Holdings LLC (DaVita), has agreed to pay $270 million to resolve its False Claims Act liability for providing inaccurate information that caused Medicare Advantage Plans to receive inflated Medicare payments, the Justice Department announced today
[EXTERNAL LINK] - Medicare Advantage Provider to Pay $270 Million to Settle False Claims Act Liabilities
[EXTERNAL LINK] - Medicare Advantage Provider to Pay $270 Million to Settle False Claims Act Liabilities
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The federal government has started penalizing Medicare Advantage insurers that have one common, glaring problem: Faulty technology systems are leading to people paying more for care and coverage than they should be
[EXTERNAL LINK] - Feds fine Medicare Advantage plans for overcharging their members
[EXTERNAL LINK] - Feds fine Medicare Advantage plans for overcharging their members
In April 2016, government auditors asked a Blue Cross Medicare Advantage health plan in Minnesota to turn over medical records of patients treated by a podiatry practice whose owner had been indicted for fraud.
Medicare had paid the Blue Cross plan more than $20,000 to cover the care of 11 patients seen by Aggeus Healthcare, a chain of podiatry clinics, in 2011.
Blue Cross said it couldn't locate any records to justify the payments because Aggeus shut down in the wake of the indictment, which included charges of falsifying patient medical files.
https://www.npr.org/sections/health...e-plans-overcharged-taxpayers-dodged-auditors
Medicare had paid the Blue Cross plan more than $20,000 to cover the care of 11 patients seen by Aggeus Healthcare, a chain of podiatry clinics, in 2011.
Blue Cross said it couldn't locate any records to justify the payments because Aggeus shut down in the wake of the indictment, which included charges of falsifying patient medical files.
https://www.npr.org/sections/health...e-plans-overcharged-taxpayers-dodged-auditors
The Justice Department today announced charges against a former executive at HealthSun Health Plans Inc. (HealthSun), a Medicare Advantage organization that operates Medicare Advantage plans in South Florida, for her role in a multimillion-dollar Medicare fraud scheme.
In addition, the Justice Department announced that it has declined prosecution of HealthSun after considering the factors set forth in the department’s Principles of Federal Prosecution of Business Organizations and the Criminal Division’s Corporate Enforcement and Voluntary Self-Disclosure Policy, including HealthSun’s prompt voluntary self-disclosure, cooperation, and remediation, as well as HealthSun’s agreement to repay the Department of Health and Human Services’ Centers for Medicare & Medicaid Services (CMS) approximately $53 million in overpayments.
[EXTERNAL LINK] - Former Executive at Medicare Advantage Organization Charged for Multimillion-Dollar Medicare Fraud Scheme
In addition, the Justice Department announced that it has declined prosecution of HealthSun after considering the factors set forth in the department’s Principles of Federal Prosecution of Business Organizations and the Criminal Division’s Corporate Enforcement and Voluntary Self-Disclosure Policy, including HealthSun’s prompt voluntary self-disclosure, cooperation, and remediation, as well as HealthSun’s agreement to repay the Department of Health and Human Services’ Centers for Medicare & Medicaid Services (CMS) approximately $53 million in overpayments.
[EXTERNAL LINK] - Former Executive at Medicare Advantage Organization Charged for Multimillion-Dollar Medicare Fraud Scheme
- 2,248
Actually he's posting the kind of stuff we need to read. But you on the other hand ....
MSO cult mentality.
- 2,248
Not hard to do. Just check out our profiles. We actually have one. Forum trolls don't.
He’s his wingman. Rooster if you will.
