Justice Department officials said from 2020 to 2023, Complete Health routinely added bogus diagnosis coding to its billing -- saying its patients had drug and alcohol dependencies as well as bipolar disorder -- that "were not clinically valid." File Photo by Bonnie Cash/UPI | License Photo
Aug. 3 (UPI) -- Florida-based Complete Health will pay a $14.1 million settlement stemming from allegations that it inflated patient diagnoses to overcharge Medicare, the Justice Department said Monday.
DOJ officials said from 2020 to 2023, the company routinely added bogus diagnosis coding to its billing -- saying its patients had drug and alcohol dependencies as well as bipolar disorder -- that "were not clinically valid."
Under Medicare Part C, also known as Medicare Advantage, the government pays a fixed monthly rate to private health providers depending on the severity of a patient's diagnosis.
This differs from Medicare parts A and B, in which a provider is paid fees per service.
