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March 31, 2020

Around the nation: DOJ sues Anthem over MA fraud allegations

Daily Briefing

    Axios reports the lawsuit is one of the biggest Medicare Advantage fraud suits ever, in today's bite-sized hospital and health industry news from California, Idaho, and Louisiana.

    • California: Airbnb on Thursday announced it will provide free housing for 100,000 health care workers and first responders who have high exposure to COVD-19, the disease caused by the new coronavirus. The company is partnering with government agencies and nonprofit partners to ensure safety. Airbnb suggests hosts list entire homes, enhance cleaning practices, and allow 72 hours between stays (Garrity, Becker's Health IT, 3/27; Airbnb release, 3/26).
    • Idaho: Gov. Brad Little (R) on Tuesday signed into law a bill that would make providing abortion a crime in the state if the Supreme Court overturned Roe v. Wade. Under the law, people who provide abortion could be charged with a felony and have their medical licenses suspended or revoked. The law includes exceptions for abortions provided in cases of rape, incest, and to save the life of the pregnant woman (Ridler, Associate Press, 3/27).
    • Indiana/District of Columbia: The Department of Justice (DOJ) last week announced it is suing health insurer Anthem over allegations of Medicare Advantage (MA) fraud. Federal prosecutors allege that the health insurer from 2014 to 2018 knowingly filed inaccurate medical coding to the federal government to increase MA payments. According to DOJ, the insurer allegedly turned "a blind eye" to the coding issues. Axios reports the lawsuit is one of the biggest MA fraud suits ever. Anthem in a statement said it plans "to vigorously defend [its] Medicare risk adjustment practices" and that "the government is trying to hold Anthem and other [MA] plans to payment standards that CMS does not apply to original Medicare" (Herman, Axios, 3/27).


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