Medicare Advantage Organization to Pay $32.5 Million

Medicare Advantage Organization to Pay $32.5 Million

Freedom Health Inc., a Tampa, Florida-based provider of managed care services, and its related corporate entities (collectively “Freedom Health”), will pay $31,695,593 to settle a whistleblower-initiated  False Claims Act case alleging the company submitted unsupported diagnosis codes to CMS, which resulted in inflated reimbursements from 2008 to 2013 in connection with two of their Medicare Advantage plans operating in Florida.  Former Freedom Health Chief Operating Officer Siddhartha Pagidipati has agreed to pay $750,000 to resolve his role in operationalizing part of the scheme in which the company made material misrepresentations to CMS about the scope of its network of providers.

The whistleblower in this case was Darren D. Sewell, a former employee of Freedom Health. The whistleblower’s share has not yet been determined.