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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Lincare Holdings, a provider of oxygen equipment and subsidiary of Linde, agreed to pay $29 million to resolve allegations it violated the False Claims Act by fraudulently overbilling Medicare.
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Booz Allen Hamilton agreed to pay approximately $377.5 million as part of a settlement with the Department of Justice regarding alleged False Claims Act violations stemming from improper billing of commercial and international costs in government contracts.
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Even though the U.S. federal government is currently shut down, the U.S. Securities and Exchange Commission appears to still be at work. The financial regulator is reportedly investigating a major insurance and asset management company over its accounting practices.
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Charlie Javice, a former CEO who duped JPMorgan Chase into purchasing her start up company for $175 million, has been ordered to forfeit more than $22 million by the Department of Justice (DOJ) and to spend 7 years in jail.
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