The Section of Justice is charging Anthem with fraud for acquiring hundreds of thousands of dollars in risk adjustment payments by inflating the severity of illness for beneficiaries in its Medicare Advantage strategies.
The civil lawsuit was submitted Friday in the U.S. District Courtroom in the Southern District of New York. The federal government wishes a jury trial to figure out financial damages and to get well restitution.
Even so, Anthem contends it has completed practically nothing improper and claimed it intends to “vigorously protect our Medicare risk adjustment practices.” The DOJ has violated the regulation in holding Medicare Advantage strategies to payment standards that are not used to regular Medicare, the enterprise claimed by assertion.
“This litigation is the most up-to-date in a collection of investigations on Medicare Advantage strategies,” Anthem claimed. “The federal government is making an attempt to keep Anthem and other Medicare Advantage strategies to payment