Ex-HealthSun Coding Director Found Not Guilty of Fraud Scheme

A former HealthSun Health Plans Inc. coding director accused of orchestrating a conspiracy to fraudulently inflate the company’s Medicare payments has been acquitted of criminal charges.

The jury returned its not guilty verdicts on June 13 following just four hours of deliberation. The trial, before Judge Kathleen M. Williams in the US District Court for the Southern District of Florida, lasted eight days.

The government has brought just a handful of criminal cases involving allegations of Medicare Advantage risk-adjustment upcoding. Seasoned health-care fraud lawyers say the cases can be difficult to make.

The defendant—Kenia Valle Boza—was charged with one count ...