U.S. Justice Department Investigates Health Insurance provider’s payments looking for potential Medicare Fraud

Monday, December 11, 2017 | | Author: | Original Article

U.S. Justice Department Investigates health insurance providers United Healthcare, Health Net Inc., Aetna Inc., Cigna Corp’s Bravo Health and Humana Inc. after allegations of Medicare Fraud are leveled by a whistleblower in a U.S False Claims Act lawsuit which was filed 2011.

United Healthcare (UHC), Health net Inc., Aetna Inc., Cigna Corp’s Bravo health and Humana Inc., are facing a storm of allegations as related to ERISA violations and fiduciary fraud. These allegations stem from a number of cases filed in Federal Courts nationwide calling into question the billing, payment, and reimbursement procedures of the insurance industry.

On March 17^th, 2017, the United States Justice Department disclosed that in addition to United Healthcare, the department had also launched investigations into four additional health insurance providers: Health net Inc., Aetna Inc., Cigna Corp’s Bravo Health and Humana Inc. This follows there partial intervention in a U.S False Claims Act lawsuit, filed in 2011 by former United Healthcare executive and whistleblower Benjamin Poehling.[1]

The disclosure follows the release of court documents pertaining to the 2011 lawsuit and unsealed in a Los Angeles Federal District Court in February. The unsealed documents revealed allegations that United Healthcare may have improperly billed Medicare in excess of a billion dollars, and that the practice may have been occurring for more than a decade.[2] The documents also alleges that the insurers defrauded Medicare by claiming patients were treated for conditions they did not have or that Medicare was billed for treatments the patients did not receive.[3]