Medicare Contractor to Pay $144-Million Fine in Payment Scam
A major Medicare contractor pleaded guilty Thursday to ripping off the program and agreed to pay the government $144 million for lying to auditors, destroying documents, discarding claims and paying others without checking them.
The settlement by Health Care Service Corp., also known as Blue Cross Blue Shield of Illinois, is the largest ever involving the third-party insurers the government uses to handle Medicare bills.
Medicare “is a system that relies on the honesty and integrity of the contractors,” Deputy Atty. Gen. Eric Holder said at a Justice Department news conference. “But instead of being honest, this contractor altered the documents and lied about its performance.”
On the basis of the exaggerated performance reports, Health Care Service Corp., which was the Medicare contractor for Illinois and Michigan, received $1.3 million in bonus payments. Much of that money was passed on to managers at the company’s Marion, Ill., processing facility.