SAN JUAN, Puerto Rico – On July 1st, 2022, the United States Attorney for the District of Puerto Rico and the U.S. Department of Health and Human Services, Office of Inspector General (HHS- OIG) announced that MCS Advantage, Inc. (MCS Advantage) has agreed to pay $4,200,000 to resolve False Claims Act allegations that it implemented a gift card incentive program in violation of the Anti-Kickback Statute.
According to the settlement agreement, the United States asserted that MCS Advantage submitted or caused to be submitted claims for payment to the Medicare Program relating to a gift card incentive program implemented by MCS during the period of November 2019 to December 2020, which the Government alleges resulted in violations of the False Claims Act and the Anti-Kickback Statute. As a result of the incentive program, MCS distributed 1,703 gift cards to administrative assistants of providers at an aggregate cost of $42,575 to induce the assistants to refer, recommend, or arrange for enrollment of 1,646 new Medicare beneficiaries to an MCS Medicare Advantage plan. Those new Medicare beneficiaries resulted in associated premium payments received by MCS Advantage for the new members.
This agreement underscores the commitment of the Justice Department and HHS- OIG to deterring fraud, waste, and abuse of federal benefit programs, as well as the benefits of cooperation with federal investigations. The negotiated settlement with MCS Advantage took into consideration the company’...
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