Humana filed a lawsuit against QuivvyTech and several physicians over an alleged scheme to fraudulently prescribe and bill for topical creams.
Five details:
1. In the lawsuit, filed in the Southern District of Florida, Humana alleges that QuivvyTech hired telemarketers to cold-call Humana members and get them to talk about common ailments. Then, the company would wire information and recordings of the cold calls to physicians, who prescribed topical creams to the Humana patients without speaking to them.
2. The defendants received the contact information of Humana members through "illegal means," the lawsuit alleges. The defendants would then tell plan members they were working with Humana and members' physicians or pharmacies to obtain health information. Many of the people targeted in the scheme lived in Florida.
2. The prescriptions were wired to pharmacies that billed and dispensed or shipped them to the Humana members. On several occasions the prescriptions were automatically refilled.
3. Humana alleges the defendants billed Humana for millions of dollars in fraudulent claims that were then paid through wire transfers. The physicians named in the suit allegedly electronically signed prescriptions for the members without reviewing patient history or having a prior relationship with the patient.
4. QuivvyTech paid the physicians for visits with Humana members that didn’t occur, according to the suit, and sometimes billed Humana members for the visits. The defendant physicians did not contact members' physicians before signing prescriptions, the suit alleges.
5. Defendants in the suit include Frank Michelin, associated with QuivvyTech; Reliable Medical Supplies and Reliable Document Solutions, a telemedicine company with about 200 physicians; and physicians Jeffrey Mahon, MD, Elie Hercule, MD, Samuel Teniola, MD, Louis Mojicar, MD, Ananda De Silva, MD, and Jeffrey Stern, MD.
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