DOJ Sues New York Health Insurer Over Medicare Fraud

The U.S. Department of Justice is suing a Buffalo, N. Y.-based health insurance company for allegedly submitting over a hundred thousand false claims to Medicare and defrauding the federal government out of tens of millions of dollars.

Independent Health Association and its subsidiary, Independent Health Corp., are accused of obtaining higher Medicare payments by implementing a risk adjustment program that, in effect, made it appear enrollees in their Medicare Advantage Plans were sicker than their medical records said they were, according to the complaint filed Monday night.

People enrolled in Medicare Advantage, also known as Medicare Part C, can enroll ...