CareSource to Pay OH $26M in False Claims Settlement
Morris said that because it is a mission-driven organization, CareSource “has always dealt with our relationship with the State of Ohio and the management of Medicaid funds with the highest integrity.”
“We have proven our not-for-profit model works in a growing for-profit health care environment. Our model is highly member-focused and demands being great stewards of taxpayer dollars spending more than 90% of every dollar we receive on quality healthcare for our members, while saving the State of Ohio hundreds of millions of dollars and providing predictability of budget. We are extremely unique in the industry,” Morris said.
The settlement resolves a federal whistleblower action filed by two former employees at CareSource, Laura Rupert and Robin Herzog, who will receive a $3.1 million share of the federal portion of the settlement.
The Justice Department has used the False Claims Act recover approximately $5.3 billion since January 2009 in cases involving fraud against federal healthcare programs. Total recoveries in False Claims Act cases since January 2009 have topped $6.8 billion.
John Commins is a senior editor with HealthLeaders Media.
- Providers' Push to Consolidate Roils Payers
- As Retail Clinics Surge, Quality Metrics MIA
- Former NQF Co-Chair Linked to Conflicts of Interest in Journal Probe
- RN Named Chief Patient Experience Officer
- No Employee Satisfaction, No Patient-Centered Culture
- Medicare Cost, Quality Data Tools Weak, Says GAO
- In PCMH, the 'P' is Not for 'Physician'
- How Simple Data Analytics is Driving Physician Incentives
- Population Health Pays Off for NY Collaborative
- AMA Pushes Lame Duck Congress for SGR Repeal