Feds investigating allegations that Humana Inc. overcharged Medicare Advantage program

The entrance to the Humana headquarters in Louisville, Kentucky. Brian Bohannon/AP

The entrance to the Humana headquarters in Louisville, Kentucky.
Brian Bohannon/AP

Giant health insurer Humana Inc. faces multiple federal investigations into allegations that it overbilled the government for treating elderly patients enrolled in its Medicare Advantage plans, court records reveal.

The status of the investigations is not clear, but they apparently involve several branches of the Justice Department. The U.S. Attorney’s Office in Miami wrote in a court document filed in March that officials expect that at least one of the probes will be completed and the findings made public “in the next few months.”

The U.S. Attorney’s branch office in West Palm Beach, Florida has opened a criminal case involving overbilling allegations that the government says is similar to the Miami investigation. Meanwhile, the criminal division of the Justice Department in Washington has reviewed fraud allegations against the company, according to court records.

Humana, which insures more than 2 million people through the Medicare Advantage plans, is also the target of two Florida whistleblower civil lawsuits that allege similar overcharges.

Federal officials disclosed their legal actions in a series of documents unsealed April 30 in one of the whistleblower suits. That suit alleges that a doctor at a clinic in South Florida inflated billings for two dozen or more Humana patients. The case, filed in September of 2010, was unsealed in federal court in Miami earlier this month. The whistleblower added new allegations of overbilling to the Miami lawsuit on Wednesday.

Humana acknowledged the unsealing of the Miami case in a May 7 Securities and Exchange Commission filing, saying it “was continuing to cooperate with and respond to information requests from the U.S. Attorney’s Office.” Humana disclosed in 2012 SEC filings that federal officials were seeking documents “relating to several matters including the coding of medical claims,” an admission that was reported at the time. But the company has offered no details.

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Feds investigating allegations that Humana Inc. overcharged Medicare Advantage program

A Whistleblower’s Profile In Courage

Obamacare threatens to maim and kill innocent people in the name of furthering the bottom line for the insurance companies. Obamacare contains the heinous specter of death panels. We are all at risk and certainly Obamacare represents yet another form of wealth distribution. However, the people should know that help is on the way.

Dr Linda PeenoDr. Linda Peeno contacted me two weeks ago and informed me that she is reinserting herself into her advocacy work on behalf of all patients who are trapped in a corrupt medical system.

If you don’t know who Linda Peeno is, the following profile should inspire all to become a force for positive change. If you remember Dr. Peeno, you will find the following information to be a welcome update on one of America’s most courageous whistleblowers.

Of all the interviews that I have conducted over the years, there is one interview which still troubles me to this day. Almost five years ago, I interviewed managed health care whistleblower, Dr. Linda Peeno, her revelations have haunted me in the years following the interview. I am haunted because Dr. Peeno gave so much to the people of America and lost nearly everything in return.

What started out as an interview with the objective consisting of presenting the listening audience with an expose on the inherent evils of health care, the interview turned into what John F. Kennedy would refer to as a shining example of a “profile in courage.” Yet, it is a profile in courage that has neither been championed or rewarded. Rather, Peeno’s statements and actions have been met with denial, derision, disdain and a highly effective and destructive retaliation.

Certainly, Linda Peeno’s trip down whistleblower lane appeared promising when the her Congressional testimony was prominently portrayed in Michael Moore’s movie, Sicko, as Peeno told Congress the following:

“I wish to begin by making a public confession: In the spring of 1987, as a physician, I caused the death of a man. Although this was known to many people, I have not been taken before any court of law or called to account for this in any professional or public forum. In fact, just the opposite occurred: I was “rewarded” for this. It bought me an improved reputation in my job, and contributed to my advancement afterwards. Not only did I demonstrate I could indeed do what was expected of me, I exemplified the “good” company doctor: I saved a half million dollars. I contend that “managed care,” as we currently know it, is inherently unethical in its organization and operation. Furthermore, I maintain that we have an industry which can exist only through flagrant ethical violations against individuals and the public.”

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A Whistleblower’s Profile In Courage