Feds probe Humana on claims, doc loans


Humana is the subject of an investigation by the U.S. Justice Department regarding its coding of medical claims and loans to physicians in South Florida.

Humana disclosed in a recent regulatory filing that the U.S. Attorney's Office in Miami made a request for documents and other information relevant to its investigation back in January, Bloomberg reported.

"We also may face litigation or further government inquiry regarding certain aspects of the Medicare and Medicaid operations of certain of our Florida subsidiaries," Humana said in its filing Monday, Reuters reported.

Humana previously had stated that it was conducting an internal investigation of its operations in Florida, involving relationships between its employees and Medicare and Medicaid providers, as well as financial support of nonprofit or provider centers and physician practices.

Last August, Florida regulators fined Humana $3.4 million, accusing it of not reporting suspected Medicaid fraud in a timely manner, CBS Miami reported. Humana is appealing the decision.

South Florida is considered a hotbed for healthcare fraud, particularly involving Medicare claims, although large companies have rarely been implicated. Federal prosecutors unsealed a raft of fraud indictments last week against alleged wrongdoers based in Miami.

To learn more:
- read the Reuters article
- read the Bloomberg article
- here's the CBS Miami article

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