A settlement has been reached to resolve False Claims Act allegations against Freedom Health Inc.
The allegations arose from a lawsuit that claimed Freedom Health Inc violated the False Claims Act by engaging in illegal schemes to maximize their payment from the government in connection with their Medicare Advantage plans.
According to the government, allegedly Freedom Health submitted or caused others to submit unsupported diagnosis codes to CMS, which resulted in inflated reimbursements from 2008 to 2013 in connection with two of their Medicare Advantage plans operating in Florida. Furthermore, allegedly Freedom Health made material misrepresentations to CMS regarding the scope and content of its network of providers (physicians, specialists and hospitals) in its application to CMS in 2008 to expand in 2009 into new counties in Florida and in other states.
Reportedly, the former Chief Operating Officer of Freedom Health, Siddhartha Pagidipati, has agreed to pay $750,000 to resolve his alleged role in one of these schemes.
“When entering into agreements with managed care providers, the government requests information from those providers to ensure that patients are afforded the appropriate level of care,” said Acting Assistant Attorney General Chad A. Readler of the Justice Department’s Civil Division. “Today’s result sends a clear message to the managed care industry that the United States will hold managed care plan providers responsible when they fail to provide truthful information.”
These allegations were brought forward by whistleblower, Dr. Sewell, who died in 2014, who worked at Freedom Health and Optimum Healthcare from 2007 to 2012 as chief medical officer before transferring to the Medicare Revenue Management Department as vice president of special projects.
Based in Tampa, Florida, Freedom Health Inc is a provider of managed care services.
