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Medicare Advantage Insurers Reach $32 Million Settlement in Whistleblower Case

A pair of Medicare Advantage insurers based in Florida agreed to pay nearly $32 million to settle a whistleblower claim. In the claim, a whistleblower alleged the insurance providers routinely exaggerated the severity of patients’ conditions and took various other steps to overbill Medicare. The suit was initially filed in 2009 by Dr. Darren Sewell, Read More

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False Claims Act Suit Against Genentech Halted

The U.S. Court of Appeals for the Third Circuit recently halted a False Claims Act lawsuit filed against Genentech Inc. In the suit, the plaintiff claimed the company defrauded Medicare by hiding some side effects of its cancer drug Avastin. The court stated the whistleblower did not show that a failure to report the safety Read More

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DOJ Claims UnitedHealth Group Overbilled Medicare by Hundreds of Millions

The U.S. Department of Justice recently sued UnitedHealth Group, claiming the company’s senior executives were aware it was overbilling Medicare by hundreds of millions of dollars annually and that they put a stop to a repayment plan in 2014 to meet revenue expectations. The official complaint was filed in May in the U.S. District Court Read More

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Whistleblower Receives $545,000 After Enforcement Action Against Bay Sleep Clinic

A sleep technician in California will receive a $545,000 award for serving as a whistleblower in a case involving the Bay Sleep Clinic and several of its affiliates. Bay Sleep Clinic recently settled the case with the U.S. Department of Justice for $2.6 million. The action stemmed from allegations that the company and its affiliates Read More

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Whistleblower Accuses Medicare Advantage Organizations of Overbilling

A Texas whistleblower has filed a lawsuit against CenseoHealth LLC and various other Medicare Advantage organizations, claiming they have been regularly overcharging Medicare for the in-home care they provide to patients. The plaintiff is Becky Ramsey-Ledesma, a former coding manager for Censeo, and she has demanded her claim be presented in a jury trial. The Read More

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Whistleblower: Medicare Advantage Overcharged for Home Visits

A whistleblower case in Texas has come into the spotlight with allegations that a medical consulting firm is overbilling Medicare for in-home patient examinations. The details of the case were unsealed in June, and it’s only the latest of at least six other whistleblower claims filed in the last five years alleging billing fraud by Read More

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$7.5 Million Settlement Reached in Whistleblower Lawsuit Alleging False Medical Records

Orbit Medical Inc. and Rehab Medical Inc. have agreed to pay a $7.5 million settlement at the close of a five-year whistleblower lawsuit. Two former employees of the companies filed the claim, and they alleged that Orbit’s top executives instructed its sales staff to create false medical records to unlawfully bill Medicare for electric wheelchairs. Read More

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Department of Justice Takes Active Role in Lawsuit Against Nursing Home Chain

For the past six years, the Ohio-based nursing home chain HCR ManorCare has been embroiled in a whistleblower lawsuit featuring allegations that the company systematically overbilled Medicare and often put its residents through overly rigorous rehabilitation schedules in efforts to increase revenue. Now the U.S. Department of Justice is stepping in, which means an end Read More

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