IBM has agreed to pay $14.8 million to settle allegations it violated the False Claims Act. IBM allegedly misrepresented product capabilities during a contract process with the Maryland Health Benefit Exchange. The exchange awarded a contract- partially funded by federal grants- to develop the state’s health insurance exchange website, with IBM named as a subcontractor for the project. However, IBM misrepresented the functionality of its software. To read more from Modern Healthcare, click here.
Several Chicago nursing centers accused of Medicare fraud will pay nearly $10 million back to the government. The therapy provider, Quality Therapy and Consultation Inc., allegedly worked with four Chicago nursing homes and billed federal health insurers for services they have never performed. The companies also lied about the level of care patients would need in order to maximize Medicare benefits with high “Resource Utilization Group” (RUG) scores. The lawsuit was originally filed by a whistleblower under the qui tam provisions of the False Claims Act. To read more from Chicago Sun Times, click here.
A federal jury found a Los Angeles doctor and a patient recruiter guilty for their roles in a $33 million Medicare fraud scheme in which Medicare was billed for home health and hospice services that patients did not need or did not receive. The patient recruiter was also convicted for recruiting patients in exchange for kickback payments. To read the full DOJ press release, click here.
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