Insurer MCS Advantage agreed to pay $4.2 million to settle allegations with federal officials that it used gift cards to get medical office workers to find new customers for its health plan . Medicare Advantage,
This was announced today in a statement issued by the Federal Prosecutor’s Office in Puerto Rico jointly with the Office of the Inspector General and the United States Department of Health.
The United States government alleged that insurer MCS Advantage submitted paid claims for the Medicare program that were related to the Gift Card Incentive Program, resulting from the False Claims Act and the Statute Prohibiting Illegal Commissions (Anti-Kickback). Violation occurred.
During the above programme, which was implemented between November 2019 and December 2020, MCS distributed 1,703 gift cards to administrative assistants of health providers, With an additional cost of $42,575.
The purpose, according to the federal statement, was to motivate these personnel to refer, recommend, or arrange for 1,646 Medicare beneficiaries to become subscribers of the MCS Medicare Advantage plan.
“Investigation of health care fraud remains a high priority at the Department of Justice and the United States Attorney’s Office, and we will aggressively pursue those who violate America’s health care laws,” he said. In writing to the federal prosecutor assigned to the District of Puerto Rico, W. Stephen Muldrow.
In reaching agreement, the federal agencies involved stated that they were committed to preventing and preventing fraud, waste and abuse of federal programs. The benefits of cooperating with the federal investigation were also highlighted, as the measure was negotiated. It is noted that MCS Advantage has voluntarily terminated the gift card program in December 2020Discloses material facts about its program and implements controls and reviews of its internal policies to ensure compliance.
The Federal Prosecutor’s Office clarified that As part of the negotiations, MCS Advantage did not accept responsibility for the allegations investigated, which were duly resolved through the settlement announced today.,