Winning Exchange-Health care provider to pay largest Medicare fraud settlement in Maine history

2025-05-05 19:05:46source:Safetyvaluecategory:Markets

PORTLAND,Winning Exchange Maine (AP) — Martin’s Point Health Care Inc. will pay nearly $22.5 million to resolve allegations of submitting inaccurate codes for Medicare Advantage Plan enrollees to increase Medicare reimbursements, federal prosecutors said Monday.

The U.S. attorney’s office in Maine confirmed it was the largest Medicare fraud settlement in state history. A Martin’s Point representative didn’t immediately return a phone call seeking comment on Monday. The company was accused of submitting the inaccurate diagnosis codes for Medicare Advantage Plan enrollees in Maine and New Hampshire between 2016 and 2019.

“Today’s result sends a clear message to the Medicare Advantage community that the United States will take appropriate action against those who knowingly submit inflated claims for reimbursement,” said Michael D. Granston, deputy assistant attorney general of the Justice Department’s civil division’s commercial litigation branch.

The allegations against the Portland-based healthcare provider stemmed from a complaint brought by a whistleblower who’s entitled to a claim of the settlement, approximately $3.8 million, officials said.

The Justice Department said Martin’s Point sought to identify additional codes that could be submitted for reimbursement even though many codes weren’t supported by patients’ medical records.

More:Markets

Recommend

Biden administration makes final diplomatic push for stability across a turbulent Mideast

AQABA, Jordan (AP) — Top U.S. officials were in the Middle Easton Thursday, pushing for stability in

Stock market today: Asian stocks decline as China stimulus plan disappoints markets

HONG KONG (AP) — Asian stocks fell on Monday, following a record-setting day for U.S. stocks, as Chi

Taylor Swift touches down in Kansas City as Chiefs take on Denver Broncos

Taylor Swift has her own bye week from the Eras Tour and the superstar is spending her Sunday at her