In its complaint, the government alleged CareMed was able to secure prior authorization for drug coverage from insurance companies by making false statements. The government alleged CareMed fabricated Medicare beneficiaries’ medical information and posed as representatives of prescribing physicians’ offices when calling insurers to obtain the authorization.
The government further alleged CareMed double billed by re-stocking unused dosages of certain drugs and then re-selling those drugs and re-billing insurance companies that provide prescription drug coverage to Medicare beneficiaries.
Of the settlement proceeds, $9.53 million will go to the U.S., and the remaining $465,423 will go to the state of New York.
Although CareMed has agreed to settle the allegations brought in the government’s complaint, there has been no admission of wrongdoing.
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