Independence Blue Cross Settles Medicare Fraud Allegations Over Diagnosis Codes
1 report, 1 independent
Updated Oct 14
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What happened
Independence Blue Cross agreed to pay to settle allegations that it defrauded Medicare. The allegations involved inflating diagnosis codes for Medicare Advantage beneficiaries. The payer stated that the issue stemmed from “industry-wide challenges” in applying Medicare Advantage risk adjustment standards.
From healthcaredive.com
Why it matters
The settlement addresses regulatory scrutiny over billing practices within the Medicare Advantage program. This action highlights the financial risks associated with how major health payers apply risk adjustment standards and manage costs for beneficiaries.
From healthcaredive.com
Who's involved
- Independence Blue CrossHealth insurance company that settled allegations of defrauding Medicare.
- MedicareUS federal health insurance program that brought the fraud allegations.
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The entities involved
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Medicare
US federal health insurance
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Independence Blue Cross
health insurance company
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