Independence Blue Cross pays $2.3M to settle false claims allegations

Independence Blue Cross agreed to pay $2.3 million to resolve accusations that two of its subsidiaries incorrectly calculated Medicare plan costs for CMS, leading to inflated reimbursement.

Advertisement

CMS contracts with Medicare Advantage plans to help manage coverage for Medicare beneficiaries. The U.S. Justice Department said Sept. 3 that Independence’s Keystone Health Plan East and QCC Insurance Co. didn’t correctly calculate its actual costs before submitting bids to CMS, leading the agency to overpay for the 2009 and 2010 contract years.

The settlement resolved a lawsuit filed by an Independence employee under the False Claims Act. Using the whistleblower provision of the False Claims Act, the employee, Eric Johnson, will receive nearly $500,000 of the settlement.

More articles on legal and regulatory issues:
Former Hacienda HealthCare CEO, CFO face felony charges
Manager of New York clinics gets 13 years in prison for kickback scheme
Dignity Health strikes $950K settlement in wage-deduction suit

Advertisement

Next Up in Legal & Regulatory Issues

  • Cincinnati-based TriHealth has signed an agreement to acquire Clinton Memorial Hospital, a 140-bed facility in Wilmington, Ohio. Once regulatory approvals…

  • Prior authorizations are increasingly straining the healthcare industry, according to a survey of 1,000 practicing physicians in the U.S. The…

  • From a new health system forming in Missouri to two Oregon systems agreeing to walk away from their proposed merger,…

Advertisement

Comments are closed.