![]() The whistleblower's share in this case has not yet been determined, the release stated. These issues were brought to light by a whistleblower, which prompted a lawsuit. It also alleged that Freedom Health made material misrepresentations in regards to the scope and content of its network of providers, which included physicians, specialists and hospitals in an application to expand its services into new counties in Florida and other states. The government alleged that Freedom Health submitted or caused others to submit unsupported diagnosis codes, which resulted in inflated reimbursements from 2008 to 2013 in connection with two of their Medicare Advantage plans operating in Florida, the release said. "With this settlement, we have agreed to disagree without any admission of liability to avoid the time and expense of prolonged litigation," he said.Īdded Freedom Health corporate counsel Bijal Patel: "Although Medicare managed care is a complex and constantly changing industry in which it is common to have differing interpretations of regulations, with this settlement, we have agreed to resolve disputed claims without any admission of liability in order to avoid delay and the expense of litigation, so that we can focus on providing quality care, member service, and maintaining the highest Medicare Star Ratings." In a statement, Pagidipati said the claims remain disputed. "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, in a statement. "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 Chad A. ![]()
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