In Settling Fraud Case, N.Y. Medicare Advantage Insurer, CEO Will Pay Up to $100M
This is a MedPage Today story. A western New York health insurance provider for seniors and the CEO of its medical analytics arm have agreed to pay a total of up to $100 million to settle Justice Department allegations of fraudulent billing for health conditions that were exaggerated or didn't exist. Independent Health Association of Buffalo, which operates two Medicare Advantage plans, will pay up to $98 million. Betsy Gaffney, CEO of medical records review company DxID, will pay $2 million, according to the settlement agreement. Neither admitted wrongdoing. "Today's result sends a clear message to the Medicare Advantage community that the United States will take appropriate action against those who knowingly submit inflated claims for reimbursement," Michael Granston, a Department of Justice (DOJ) deputy assistant attorney general, said in announcing the settlement on December 20. Frank Sava, a spokesperson for Independent Health, said in a statement: "The assertions by the DOJ...
This is a MedPage Today story.
A western New York health insurance provider for seniors and the CEO of its medical analytics arm have agreed to pay a total of up to $100 million to settle Justice Department allegations of fraudulent billing for health conditions that were exaggerated or didn't exist.
Independent Health Association of Buffalo, which operates two Medicare Advantage plans, will pay up to $98 million. Betsy Gaffney, CEO of medical records review company DxID, will pay $2 million, according to the settlement agreement. Neither admitted wrongdoing.
"Today's result sends a clear message to the Medicare Advantage community that the United States will take appropriate action against those who knowingly submit inflated claims for reimbursement," Michael Granston, a Department of Justice (DOJ) deputy assistant attorney general, said in announcing the settlement on December 20.
Frank Sava, a spokesperson for Independent Health, said in a statement: "The assertions by the DOJ...
What's Your Reaction?
.gif)
