Florida’s VIPcare Must Face Whistleblower’s Medicare Fraud Suit

Florida Medical Associates LLC—which does business as VIPcare—and others must defend themselves against a whistleblower’s suit alleging that they violated the False Claims Act by submitting improperly inflated claims to Medicare Advantage, a federal district court said.

Family physician Clarissa Zafirov adequately alleged that the defendants artificially increased risk adjustment scores of Medicare Advantage beneficiaries without regard to their actual physical condition, which led to increased reimbursements from the government, Judge Tom Barber of the US District Court for the Middle District of Florida said in a Monday order.

Under Medicare Advantage, beneficiaries can enroll in managed care insurance plans. ...