US Family Health Plan Alliance Accused of Hiding Excess Payments
U.S. Prosecutors: Overpayments Persisted Despite Known Errors
By JOSH MITCHELL
Editor
River Mississippi News
UNITED STATES — The United States has filed False Claims Act litigation against a U.S. veteran health program charging that groups of insurers overbilled military families, kept the excess money and hid their alleged fraud, federal prosecutors announced today.
The lawsuits allege that insurers within the Uniformed Services Family Health Plan overcharged for veteran health services.
The excessive revenue was handed over to the insurance group’s umbrella organization — US Family Health Plan Alliance — federal justice officials said in a Wednesday DOJ news release.
These actions violate the False Claims Act, the federal prosecutors asserted.
U.S. government officials also announced a settlement against Department of Defense contractor Kennell & Associates Inc., which is related to the False Claims Act case against Uniformed Services Family Health Plan and US Family Health Plan Alliance.
The six health insurance companies named in the federal government’s False Claims Act lawsuit are:
Brighton Marine Health Center, CHRISTUS Health Services, Johns Hopkins Medical Services Corporation, Martin’s Point Health Care, Pacific Medical Center and St. Vincent’s Catholic Medical Centers of New York.
Moreover, DOJ officials charge that the group of health insurers under the USFHP banner became aware of inflated cost errors over a decade ago in June of 2012.
However, DOJ says, the military insurers “took steps to conceal the existence of the overpayments from the government and continued to submit invoices at the inflated payment rates.” They persisted in these actions despite knowing that veterans were receiving inflated medical bills, prosecutors charge.
Taxpayer money for military healthcare should not be wasted to line the pockets of health insurance program administrators who are supposed to serve veterans, said Principal Deputy Assistant Attorney General Brian M. Boynton in the Wednesday release.
“Contractors have an obligation to return overpayments, and we will hold accountable contractors that knowingly and improperly retain such funds,” Boynton, who leads the DOJ’s Civil Division, said in Wednesday’s news release.
The DOJ release asserted that U.S. Defense contractors who ultimately defraud U.S. military members and their families will be held “accountable for their actions.”
