A New York health insurer and its former executive have agreed to pay up to $100 million to settle claims that they exaggerated the health status of their Medicare members to receive more money from the government. The government’s lawsuit alleged that Independent Health and its subsidiary manipulated medical records to boost their Medicare Advantage payments, with the former CEO pressuring doctors to sign off on false diagnoses. This case is significant because it targeted both the insurer and the vendor involved in the fraudulent scheme. The government has filed similar lawsuits against other insurers for Medicare Advantage fraud.
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Independent Health Medicare fraud settlement over improper diagnoses
