Today on Fraud in America, we’re covering a case involving a massive fraud on Medicare Advantage (also known as Medicare Part C).
In 2021, Sutter Health settled a whistleblower lawsuit for $90 million that alleged Sutter intentionally or recklessly submitted inaccurate medical diagnosis codes, inflating its reimbursements from Medicare Advantage.
The whistleblower on this case, Kathy Ormsby, joins us today to discuss her journey, the case, and how this type of fraud puts patient safety at risk.
In addition to Kathy, Kate Scanlan, her lawyer, joined as well. Kate is a Partner at Keller Grover.
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Fraud in America is made possible by the generous donation of longtime TAF supporter and whistleblower attorney David L. Haron!
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“Fraud in America” is produced by Jeb White, James King, Emma Bass, and Jacklyn DeMar; research by Kathleen Scanlan and Max Voldman; edited by Rachel Brooks; original music by Connor Kaos.
Fraud in America is a project of Taxpayers Against Fraud Education Fund, a 501(c)(3) organization. You can learn more about it at taf.org.