The government contracts with private health insurers to administer the Part D benefit, which offers prescription drug coverage for more than 54 million Americans on Medicare.
By law, insurers must offer plans that cover a minimum required amount of drug costs. When plans submit annual bids to the CMS to participate in Part D, they have to report their proposed benefits and confirm that those benefits meet Part D’s minimum standard.
Whistleblower Steven Scott filed the lawsuit in 2016 alleging that Humana was inflating its costs in order to get a higher paying contract from the government, though the insurer was providing below the required level of coverage. Humana pocketed the difference — which amounted to hundreds of millions of dollars — as profit, according to Scott’s suit, which was filed under the False Claims Act.
Scott also alleged that Humana maintained two sets of books to...
Topline Alexander Smirnov, the former FBI informant who was accused earlier this year of making false statements about President Joe Biden and his son Hunter Biden, was indicted Tuesday on unrelate...