WellPoint To Pay $9.25M to Settle Blue Cross of California Medicare Fraud Charges
Thousand Oaks, Calif.-based health insurer WellPoint Health Networks Inc. has agreed to pay $9.25 million to settle charges that its Blue Cross of California subsidiary defrauded Medicare, Department of Justice officials said yesterday, Bloomberg News/Los Angeles Times reports. Federal officials alleged that Blue Cross falsified audit information "so the government would believe that the company performed more audits of Medicare reports than it did" (Bloomberg/Los Angeles Times, 7/30). Blue Cross had contracted with CMS to audit Medicare claims and cost reports in California from 1990 to Nov. 30, 2000 (Reuters/New York Times, 7/30). The allegations against Blue Cross first appeared in a whistleblower lawsuit filed under the False Claims Act by a former Blue Cross auditor (Department of Justice release, 7/29). Thomas Geiser, general counsel for Blue Cross, said, "We cooperated fully with the government and decided to settle this matter to avoid prolonged litigation regarding a business we no longer operate" (Bloomberg News/Los Angeles Times, 7/30).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.