What a $541 Million False Claims Act Settlement Teaches Healthcare Organizations About Compliance
Another day, another False Claims Act (FCA) allegation—and this time, it’s a big one. The U.S. Department of Justice (DOJ) announced a healthcare provider agreed to a settlement exceeding $541 million to resolve allegations that unsupported diagnosis codes were submitted to Medicare Advantage Organizations, resulting in inflated payments from the Medicare program. According to the DOJ, the alleged conduct involved diagnosis codes that lacked sufficient documentation in the medical record or were based on improper…
