Free Consultation Hablamos EspaƱol
Phone: 727-315-1685

California Firm Agrees To Pay $30 Million To Settle Medicare Part C Fraud Allegations

doctor-563428_640.jpg

A California healthcare services provider last week agreed to pay the Federal government $30 million to settle claims that its affiliates submitted false information to Medicare in an effort at obtaining inflated repayments.

Federal investigators say the firm and its affiliates sent inaccurate information regarding Medicare Advantage Plans (a/k/a Medicare Part C) enrollees, who have the option of participating in Medicare Advantage Plans (MA Plans) that are owned and operated by Medicare Advantage Organizations (MAOs). Payouts on MA Plans are based upon demographic criteria describing risk factors for the individual subscribers, quantified into a risk score. More severe diagnoses result in higher risk scores which, in turn, yield higher payouts.

Per prosecutors, the defendant contracted with MAOs in exchange for a share of the payouts. In order to increase payouts, investigators say the defendant submitted diagnoses to partner MAOs that were more severe than the diagnoses actually were, thereby unjustly receiving inflated payouts on said diagnoses.

The settlement in question comes shortly after a separate but affiliated firm was indicted by federal prosecutors for violating the False Claims Act (a/k/a the "Lincoln Law") for submitting unsupported diagnoses scores to federal medical insurance programs.

The Law Offices of Bjorn Brunvand have been representing people charged with capital murder, felony drug charges, drunk driving, government fraud, and white-collar crimes for over a quarter century. Contact our office today to discuss your Tampa Bay-area state or federal charges.

No Comments

Leave a comment
Comment Information
  • American inns of court
  • norml
  • National association of criminal defense lawyers
  • Clearwater bar association
  • Florida Association of Criminal Defense Lawyers

Let Us Help You

Bold labels are required.

Contact Information
disclaimer.

The use of the Internet or this form for communication with the firm or any individual member of the firm does not establish an attorney-client relationship. Confidential or time-sensitive information should not be sent through this form.

close

Privacy Policy

Clearwater Office
615 Turner Street
Clearwater, FL 33756

Phone: 727-315-1685
Phone: (727) 446-7505
Fax: 727-446-8147
Clearwater Law Office Map

Tampa Office
902 N. Armenia Avenue
Tampa, FL 33609

Phone: 727-315-1685
Map & Directions

Please Direct All Correspondence to the Clearwater Office