Florida has fined health insurer Humana $3.3 million for failing to promptly disclose Medicaid fraud to state investigators, according to a Sun Sentinel report.
Health regulators say that since 2009, Humana has not reported what it knew about suspected fraud by physicians, hospitals or Medicaid recipients. Letters from Mike Blackburn, chief Medicaid inspector general at the Agency for Health Care Administration, did not specify what instances of fraud or abuse the company failed to promptly disclose, according to the report.
Law requires Medicaid HMOs to disclose fraud or abuse within 15 days of discovering it. Humana has been charged a $1,000 penalty for each day it did not report, which results in a $2.7 million fine. A second fine of $660,000 — or $200 a day — was applied since Humana's failure to disclose violated its contract terms as a Medicaid HMO.
Read the Sun Sentinel report on Humana and Florida.
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Health regulators say that since 2009, Humana has not reported what it knew about suspected fraud by physicians, hospitals or Medicaid recipients. Letters from Mike Blackburn, chief Medicaid inspector general at the Agency for Health Care Administration, did not specify what instances of fraud or abuse the company failed to promptly disclose, according to the report.
Law requires Medicaid HMOs to disclose fraud or abuse within 15 days of discovering it. Humana has been charged a $1,000 penalty for each day it did not report, which results in a $2.7 million fine. A second fine of $660,000 — or $200 a day — was applied since Humana's failure to disclose violated its contract terms as a Medicaid HMO.
Read the Sun Sentinel report on Humana and Florida.
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