Humana settles fraud case

Article Abstract:

Humana Health Care Plans will pay $14.5 million to settle a federal lawsuit accusing the HMO of overcharging government health programs. Federal investigators said Humana claimed some patients were eligible for both the federal Medicare programs and the states' Medicaid programs when they were not. Medicare pays twice more in premiums to HMOs that cover patients eligible for both programs. The investigators added that Humana fraudulently claimed $3.5 million from Medicare from 1990 to 1999.

Humana Health Care Plans Inc.

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Humana lawsuit claims incentives limit care

Article Abstract:

Humana Health Care Plans Inc is facing a class-action lawsuit filed in a Miami, FL, district court. The lawsuit, which was brought under federal racketeering law, claims that the company committed a fraudulent act when it failed to disclose incentives given to claims reviewers and doctors to limit medical coverage. Experts believe that the case could face such impediments as presentation of proof patients were harmed in the process.

Medical Care Insurance, Direct Health and Medical Insurance Carriers, Humana Health Care Plans Inc

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HMO plan lets elderly stay home

Article Abstract:

An experiment by Medicare, called Social Health Maintenance Organization (HMO), allows elderly people to spend the rest of their lives in their homes instead of a nursing home. Due to this type of health plan Social HMOs are growing at a time when other Medicare HMOs are struggling. However, Social HMOs are now being questioned for their ability to save government money. The issue will soon be debated in Congress.

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