Medicare Advantage Provider Pays $6.3 Million to Settle FCA Allegations


Weekly Newsletter | November 20, 2020 | Subscribe


COVID-19 Related Fraud

----------------------------------------------------------------------------------- Dept. of Justice: Dayton business owner pleads guilty to COVID relief fraud An Ohio business owner allegedly sought $1.3 million in forgivable loans and $1.2 million from the SBA by claiming to have 73 employees earning wages at Extract LLC, a Dayton-based private investigation and security services business.


Dept. of Justice: Seven Charged in Connection with a COVID-Relief Fraud Scheme Involving more than 80 Fraudulent Loan Applications Worth Approximately $16 Million Seven individuals were charged for their alleged participation in a scheme to obtain approximately $16 million in Paycheck Protection Program loans. At least 80 fraudulent applications were allegedly filed, and the money was allegedly spent on luxury items such as Porsche and Lamborghini cars.


NBC Los Angeles: Brothers and Wives Charged in $5.6 Million COVID-19 Loan Scheme Two brothers and their wives have been charged in an alleged scheme to submit at least 35 fraudulent applications seeking more than $5.6 million in COVID relief loans. The defendants allegedly used the money for luxury homes including a down payment for a $3.25 million residence.


New York Post: COVID-19 aid program doled out $7.2M for man’s fake farming firms: report A man received $7.2 million intended for agricultural businesses struggling during COVID-19. At his residence, 20 companies are allegedly registered with names such as Organic Ohio Berries LLC and Garlic Farming LLC; however, there are no signs of farming-related activities.


CBS Chicago: Woman Headed to Prison for Fraud Obtained COVID-Relief Loan A Chicago woman who was heading to prison for allegedly stealing millions of dollars through her boyfriend’s business credit card allegedly obtained a pandemic relief loan as she was preparing to report to prison. She allegedly obtained $150,000 after lying on applications for an Economic Injury Disaster Loan application and failed to disclose her fraud conviction or her prison sentence.


Case Settlements & Opinions

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Dept. of Justice: Medicare Advantage Provider to Pay $6.3 Million to Settle False Claims Act Allegations

Kaiser Foundation Health Plan of Washington agreed to pay $6.3 million to settle allegations that it submitted invalid diagnoses to Medicare for Medicare Advantage beneficiaries and, as a result, received inflated payments from Medicare.





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