AmeriHealth Mercy Health Plan reached a $2 million settlement with Kentucky Attorney General Jack Conway following a nine-month Medicaid fraud investigation, Conway's office announced.
Ky. plan administrator to pay $2 million in fraud settlement
University Health Care, Louisville, Ky., contracted with AmeriHealth in 2009 to manage Passport Health Plan, a health management organization sponsored by the University of Louisville Medical School Practice Association and other provider groups. Conway's office alleged that AmeriHealth falsely reported a cancer screening score in 2009 that resulted in a bonus payment from University Health Care.
Under the terms of the settlement, AmeriHealth does not admit any wrongdoing and denies any intent to misrepresent data. According to an AmeriHealth news release, the company "fully cooperated with the attorney general's investigation in this matter and assisted in bringing this to a prompt and satisfactory conclusion." Also, according to the release, AmeriHealth returned the bonus payment before the settlement was reached, and the workers involved, all of whom were "low- to mid-level employees," are no longer with the company.
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