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Aftershocks of the Feds' Big Bust: Lessons Learned

Posted  07/18/17
By the C|C Whistleblower Lawyer Team Listen to RAC Monitor's broadcast program, "Aftershocks of the Feds' Big Bust: Lessons Learned," featuring Constantine Cannon Partner, Mary Inman. Ms. Inman discusses the DOJ's recent Health Care Fraud Takedown and the prosecution of medical professionals involved in opioid-related crimes as a DOJ health care enforcement priority (at 21:30 of the broadcast). Click here for more.

Freedom Health, Optimum Healthcare and Its Former COO to Pay $32.5 Million to Settle False Claims Act Allegations of Medicare Fraud

Posted  05/31/17
By the C|C Whistleblower Lawyer Team Yesterday, the Department of Justice and Constantine Cannon, LLP announced that they had reached a settlement with Freedom Health and Optimum Healthcare, two large health insurers and operators of Medicare managed healthcare insurance plans controlled by Dr. Kiranbhai “Kiran” C. Patel and based in Tampa, Florida, to resolve allegations of systemic Medicare and Medicaid...

United States Files Complaint-in-Intervention in Constantine Cannon Whistleblower’s Case Against UnitedHealth Group

Posted  05/17/17
The Department of Justice announced yesterday that it has filed a complaint-in-intervention against UnitedHealth Group (UHG) in a case brought by Constantine Cannon client Ben Poehling.  The government’s complaint alleges that UHG knowingly obtained inflated risk adjustment payments from Medicare Advantage based upon false information regarding the health of beneficiaries in its plans. UHG is the nation’s...

United States Intervenes in Constantine Cannon Whistleblower’s suit against UnitedHealth Group, WellMed Medical Management

Posted  02/16/17
By the C|C Whistleblower Lawyer Team The U.S. Department of Justice has joined Constantine Cannon in bringing a whistleblower’s False Claims Act lawsuit against UnitedHealth Group, the nation’s largest health insurer and largest operator of Medicare managed healthcare insurance plans. The suit alleges UnitedHealth and its various subsidiaries and affiliates defrauded Medicare by improperly inflating its risk...

Medicare Part C: Fighting Back Against Risk Adjustment Fraud

Posted  06/26/15
Health insurance companies that participate in the Medicare Managed Care program (also known as Medicare Advantage or Medicare “Part C”) routinely complain about cuts to their reimbursement rates – even in years, like this one, where the reimbursement rates are actually increased.  At the same time, reports indicate that insurers are “leaning heavily on their Medicare business” and “signal[ing their]...