DOJ accuses Anthem of fraud in risk adjustment payments for its Medicare Advantage plans

Jannie Delucca

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

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Trump accuses hospitals of hoarding ventilators and other supplies during coronavirus pandemic

Jannie Delucca

At a White House coronavirus process drive briefing on Sunday, President Donald Trump speculated that some hospitals are hoarding ventilators and other healthcare tools, together with facemasks, throughout the COVID-19 coronavirus crisis.

Trump did not point out any facilities by identify, and made available no evidence that hospitals had been hoarding the tools. He only mentioned that some hospitals, which experienced previously positioned orders for ten to 20,000 masks, are now asking for upwards of three hundred,000 masks and insinuated that healthcare facilities may be hiding some thing.

“How do you go from ten to 20 to three hundred,000?” Trump questioned aloud throughout the briefing. “Ten to 20,000 masks to three hundred,000, even however this is distinct. Something’s likely on, and you need to have to search into it as reporters. In which are the masks likely, are they likely out the again doorway? And we have that in a

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