![]() ![]() The whistleblower’s share in this case has not yet been determined. Sewell, who was a former employee of Freedom Health. The whistleblower in this action is Darren D. ![]() These statutes permit private parties to sue on behalf of the government for false claims and to receive a share of any recovery. The allegations resolved by these settlements were brought in a lawsuit under the qui tam, or whistleblower, provisions of the Federal False Claims Act and the Florida False Claims Act. Moving forward, the innovative CIA reduces the risks to patients and taxpayers by focusing on compliance issues unique to Medicare Advantage plans.” “OIG will investigate and hold managed care organizations accountable for fraud. “Medicare Advantage insurers must play by the rules and provide Medicare with accurate information about their provider networks and their patients’ health,” said Chief Counsel to the Inspector General Gregory Demske of the Department of Health and Human Services Office of Inspector General (HHS-OIG). “This settlement underscores our Office’s commitment to civil health care fraud enforcement.” ![]() “Medicare Advantage plans play an increasingly important role in our nation’s health care market,” said Acting U.S. Pagidipati resolves his alleged role in this latter scheme. It also alleged that Freedom Health made material misrepresentations to CMS regarding the scope and content of its network of providers (physicians, specialists and hospitals) in its application to CMS in 2008 to expand in 2009 into new counties in Florida and in other states. The government alleged that Freedom Health submitted or caused others to submit unsupported diagnosis codes to CMS, which resulted in inflated reimbursements from 2008 to 2013 in connection with two of their Medicare Advantage plans operating in Florida. “Today’s result sends a clear message to the managed care industry that the United States will hold managed care plan providers responsible when they fail to provide truthful information.” Readler of the Justice Department’s Civil Division. “ When entering into agreements with managed care providers, the government requests information from those providers to ensure that patients are afforded the appropriate level of care,” said Acting Assistant Attorney General Chad A. In addition, the former Chief Operating Officer (COO) of Freedom Health Siddhartha Pagidipati, has agreed to pay $750,000 to resolve his alleged role in one of these schemes. For more information about Medicare including a complete listing of plans available in your service area, please contact the Medicare program at 1-800-MEDICARE (TTY users should call 1-87) or visit Medicare has neither reviewed nor endorsed this information.Freedom Health Inc., a Tampa, Florida-based provider of managed care services, and its related corporate entities (collectively “Freedom Health”), agreed to pay $31,695,593 to resolve allegations that they violated the False Claims Act by engaging in illegal schemes to maximize their payment from the government in connection with their Medicare Advantage plans, the Justice Department announced today. Each Blue Cross Blue Shield company is responsible for the information that it provides. To find out about premiums and terms for these and other insurance options, how to apply for coverage, and for much more information, contact your local Blue Cross Blue Shield company. ![]() Enrollment in these plans depends on the plan’s contract renewal with Medicare. Medicare Advantage and Prescription Drug Plans are offered by a Medicare Advantage organization and/or Part D plan sponsor with a Medicare contract. Plans are insured and offered through separate Blue Cross and Blue Shield companies. Viewing this Medicare overview does not require you to enroll in any Blue Cross Blue Shield plans. Medicare overview information on this website was developed by the Blue Cross and Blue Shield Association to help consumers understand certain aspects about Medicare. ![]()
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