Aetna to Pay $117.7m to Settle Medicare Fraud Claims: DOJ

Aetna agreed to pay $117.7m to resolve allegations it inflated Medicare Advantage payments by submitting inaccurate diagnosis codes, according to the Department of Justice.

• Settlement resolves False Claims Act allegations tied to Medicare Advantage data
• US alleges Aetna submitted inaccurate, untruthful diagnosis codes to boost risk-adjusted payments
• Company allegedly failed to withdraw unsupported codes and repay CMS
• Aetna also accused of falsely certifying data accuracy to CMS

To contact the reporter on this story:
Georgi Azar in New York at gazar4@bloomberg.net

To contact the editor responsible for this story:
Ilya Banares at ibanares@bloomberg.net

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