The Justice Department has begun a federal investigation into Louisville, Ky.-based Humana over allegations the health insurance company overcharged the government for services provided to patients enrolled in Medicare Advantage plans, according to The Center for Public Integrity.
The criminal division of the Justice Department in Washington, D.C., along with the U.S. Attorney's Office in West Palm Beach, Fla., is reviewing fraud allegations made against Humana that first came to light in two whistle-blower lawsuits filed against the company.
The first lawsuit was field in Miami and alleges Humana overbilled the government for services provided to some of its patients enrolled in Medicare Advantage plans. The suit alleges the bills for at least 24 Humana patients treated at Miami-based Plaza Medical Centers were inflated, and further alleges Humana knew about the inflated billing and took no action to stop it from occurring. The suit was filed by a former physician of the clinic, according to the report.
The second whistle-blower lawsuit was filed in federal court in West Palm Beach, Fla., and contains allegations that are very similar to those in the Miami case, according to the report.
Although the details of the federal criminal investigation are still unclear, it is unusual the Justice Department is performing a criminal probe into Humana since health insurers rarely face criminal investigations concerning billing issues, according to the report.
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