Independent Health Association of Buffalo and CEO Betsy Gaffney agreed to pay up to $100 million to settle Justice Department allegations of fraudulent billing for exaggerated or nonexistent health conditions. The settlement includes a payment of up to $98 million from Independent Health and $2 million from Gaffney. The settlement is not an admission of wrongdoing, and payments will depend on the health plan’s financial performance. This settlement, one of the largest in Medicare Advantage history, was initiated by whistleblower Teresa Ross and accused a data mining firm of helping a health plan overcharge through false billing practices.
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In Settling Fraud Case, New York Medicare Advantage Insurer, CEO Will Pay up to $100M
