Medicare Advantage Fraud

DOJ Secures $56.6M False Claims Act Settlement Concerning Alleged Medicare Advantage Fraud

By the Constantine Cannon Whistleblower Team Last week (on June 3), Nashville-based Matrix Medical Network, HealthFair, and HealthFair’s founder Shahriah Ekbatani agreed to pay $56.5 million to settle allegations they violated the False Claims Act by causing the submission of false or invalid diagnosis codes to the Medicare Advantage program.[1]  It is just the latest in an ongoing string of False Claims Act...

Kaiser Pays Record $556M to Settle Medicare Advantage False Claims Act Case -- Constantine Cannon Represented One of the Originating Whistleblowers

By the Constantine Cannon Whistleblower Team Last Wednesday (January 14), the Department of Justice (DOJ) announced that several affiliates of Oakland-based Kaiser Permanente agreed to pay $556 million to settle allegations they violated the False Claims Act by submitting invalid diagnosis codes for their Medicare Advantage patients to secure inflated payments from the Government.[1] It is the largest False...

DOJ Announces Major Medicare Advantage Fraud Settlement - Brought By a Whistleblower Of Course

By the Constantine Cannon Whistleblower Team On March 26, California-based Seoul Medical Group Inc. and its subsidiary Advanced Medical Management agreed to pay $58,740,000 to settle Department of Justice (DOJ) and whistleblower charges they violated the False Claims Act by bilking the Medicare Advantage program out of millions of dollars through false diagnoses of their patients.  Seoul Medical's former founder...

Independent Health to Pay $98M to Resolve Medicare Advantage Fraud Allegations

On December 29, 2024, the government announced that Buffalo, New York’s Independent Health Association and Independent Health Corporation (collectively known as Independent Health) have agreed to pay up to $98 million to settle allegations that they violated the False Claims Act by submitting, or causing the submission of, invalid diagnosis codes to Medicare for Medicare Advantage Plan enrollees. Constantine Cannon