Senior living: In settling fraud case, Medicare Advantage insurer, CEO will pay up to $100M
By Fred Schulte, KFF Health News
A western New York health insurance provider for seniors and the CEO of its medical analytics arm have agreed to pay up to $100 million to settle Justice Department allegations of fraudulent billing for health conditions that were exaggerated or didn’t exist.
Independent Health Association of Buffalo, which operates two Medicare Advantage plans, will pay up to $98 million. Betsy Gaffney, CEO of medical records review company DxID, will pay $2 million, according to the settlement agreement.
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