Tampa, Fla.-based Freedom Health, a managed care services provider, and its former COO have agreed to pay the federal government a combined $32.5 million to resolve allegations they violated the False Claims Act, according to the Department of Justice.
The government alleged two of Freedom Health's Medicare Advantage plans submitted unsupported diagnosis codes to CMS, which inflated Medicare reimbursements to the plans from 2008 to 2013.
The government further alleged Freedom Health misrepresented the scope of its network of providers to CMS. The misrepresentations were allegedly made in an application Freedom Health submitted to CMS in 2008 to expand into additional counties in Florida and other states in 2009. The government claims Freedom Health's former COO Siddhartha Pagidipati was involved in this scheme.
Under the settlement, Freedom Health and its related corporate entities have agreed to pay $31.7 million and Mr. Pagidipati has agreed to pay $750,000 to resolve the government's allegations, according to the DOJ.
The allegations against Freedom Health and Mr. Pagidipati were originally brought under the qui tam, or whistle-blower, provisions of the False Claims Act.
More articles on legal and regulatory issues:
12 latest lawsuits involving hospitals
Pennsylvania hospital to pay $491k to settle false billing case
Ex-employee admits recording people using SD hospital's bathroom