DOD health contractors rack up more than $100M in excess payments, DOJ alleges
By 
Adrianne Appel2025-02-18T20:08:00
Six health centers that contracted with the Department of Defense (DOD), intentionally overbilled the government for more than $100 million, the Department of Justice (DOJ) alleged in announcing a settlement with one of the plans.
The six plans, which includes The Johns Hopkins Medical Services Corporation and SVCMC Inc., formerly known as St. Vincents Catholic Medical Centers of New York, provide healthcare to active and retired military personnel and their families through the Uniformed Services Family Health Plan. The DOJ has reached a $29 million settlement with SVCMC and it is pursuing claims against the other five.
In 2012, SVCMC noticed that the government had made a mistake and labeled their patients as sicker than they actually were, resulting in a higher reimbursement rate, the DOJ said.
Related articles
-
Basic PageFCA enforcement rising across sectors, experts say
Federal agencies, including the Department of Justice (DOJ) and Customs and Border Protection, are expected to significantly alter the enforcement scope of the False Claims Act to reflect the enforcement priorities of the Trump Administration, experts speaking at Compliance Week’s Women in Compliance Summit in Austin, Texas.
-
News BriefInterim DOJ Civil Division head nominated to take on full role
President Donald Trump announced his intent to nominate Brett Shumate, the current acting head of the Civil Division at the Department of Justice, to assistant attorney general of the division. Shumate’s nomination to the arm of the DOJ that primarily handles civil cases comes at a time when Trump’s administration ...
-
News BriefArizona couple pleads guilty in vast $1.2B skin graft false claims case
Two owner-operators of three Arizona medical companies have pleaded guilty to billing more than $1.2 billion in false and fraudulent claims to Medicare and other government health programs in less than two years, the Department of Justice said.
More from Regulatory Enforcement
-
ArticleFATF focus on criminal asset recovery points to a more investigatory role for compliance
Global organised crime is booming, and only 1 to 2 percent of the $4 trillion black economy is intercepted, according to figures from the Financial Action Task Force. Its new guidance suggests that countries should focus on rapid investigations, collaborative intelligence gathering, and confiscating the proceeds of criminal activity.
-
ArticleCrypto network Paxful will plead guilty to BSA violations, pay $4M fine, shut down
Paxful, a crypto peer-to-peer network, will plead guilty to multiple federal criminal charges related to violations of the Bank Secrecy Act (BSA), among others. The plea agreement follows years of scrutiny from regulators over anit-money laundering (AML) compliance failures.
-
ArticleFormer Credit Suisse compliance officer charged with money laundering
A compliance officer is facing charges for laundering $7 million in a complex legal case in Switzerland. Swiss prosecutors have charged Credit Suisse, and one of its former employees, with failing to maintain adequate controls.