By Jeff Dale2023-07-31T18:55:00
A Maine-based healthcare provider will pay nearly $22.5 million to settle allegations it violated the False Claims Act by knowingly submitting inaccurate diagnosis codes for Medicare enrollees to increase reimbursements.
Martin’s Point Health Care, which operates Medicare Advantage plans for beneficiaries living in Maine and New Hampshire, allegedly submitted risk scores for patients that did not match their medical records, the Department of Justice (DOJ) said in a press release Monday.
The settlement resolves a lawsuit brought under the qui tam provisions of the False Claims Act by Alicia Wilbur, a former manager in the risk adjustment operations group at Martin’s Point. Wilbur will receive approximately $3.8 million.
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Oliver Street Dermatology Management, doing business as U.S. Dermatology Partners, agreed to pay nearly $8.9 million to settle allegations by the Department of Justice regarding apparent violations of the False Claims Act.
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Tractor Supply Company has agreed to get into compliance with California’s consumer privacy law and to pay a $1.35 million fine—the largest yet by California—to settle allegations it violated the privacy rights of customers and job applicants.
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A single $33,000 shipment to Iran triggered a six-figure penalty and years of compliance oversight for biotechnology company LuminUltra Technologies, Inc.
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