US Prosecutors in New York Sue Anthem for Medicare Fraud

Anthem Inc. overcharged the U.S. government by millions of dollars for services provided to Medicare patients, according to a fraud lawsuit filed by prosecutors.

The U.S. Attorney’s office in Manhattan alleges that the medical insurance giant jacked up its Medicare reimbursement by submitting inaccurate diagnostic data for hundreds of thousands of patients covered by Medicare Plan C.

Anthem’s “chart review program” was supposed to check the accuracy of what it had previously billed. But the program only added new claims for reimbursement while failing to weed out unsubstantiated charges, according to the complaint filed Thursday in federal court.

“Anthem made ‘revenue enhancement’ the sole purpose of its chart review program, while disregarding its obligation to find and delete inaccurate diagnosis codes, because Anthem prioritized profits over compliance,” prosecutors alleged.

Anthem didn’t immediately respond to request for comment after regular business hours.