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Justice Department Targets Data Mining in Medicare Advantage Fraud Case

The Justice Department has accused an upstate New York health insurance plan for seniors and its medical analytics company of cheating the government out of tens of millions of dollars. The civil complaint of fraud, filed late Monday, is the first by the federal government to target a data mining company for allegedly helping a Medicare Advantage program game federal billing regulations to overcharge for patient treatment. The suit names the medical records review company DxID and Independent Health Association, of Buffalo, which operates two Medicare Advantage plans. Betsy Gaffney, DxID’s founder and CEO, also is named as a defendant. DxID, which shut down in August, is owne...

Read the full post at Syndicate – Kaiser Health News
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