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Humana’s Slow Response to Fraud Prompts Hefty Fine from Florida

by Andrew Barr on August 23, 2011

From as far back as September of 2009, the HMO did not report its knowledge of Medicaid fraud and abuse, according to Florida state investigators. The problem may go deeper than simply ignoring fraud, however. According to the Sun Sentinel:

The investigation is looking into potentially improper loans or financial assistance the company made to Florida providers, including physician groups, and improper relationships between company employees and providers, the company said in public documents filed in May.

…the state fined the company $2.7 million — at $1,000 a day per violation — for not disclosing fraud or abuse as the law requires Medicaid HMOs to do within 15 days of discovering it.

A second fine of $660,000 — at $200 a day — says the company’s failure to disclose the fraud violates the terms of its contract as a Medicaid HMO.

More here.

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