Florida Doctor Says False Diagnoses Inflate Bills, Could Harm Patients

Insurance giant Humana Inc., which operates some of the nation’s largest private Medicare health plans, knew for years of billing fraud at some South Florida clinics but did little to curb the practice even though it could harm patients, a doctor alleges in a newly unsealed whistleblower lawsuit.

The suit was filed by South Florida physician Mario M. Baez. It accuses Humana and Baez’s former business partner, Dr. Isaac K. Thompson, of engaging in a lucrative billing fraud scheme that lasted for years. The suit also names three other Palm Beach County doctors, two medical clinics and a doctors’ practice group as defendants. The suit was filed in October 2012 but remained under a federal court seal until Feb. 26.

Humana had no comment. “As a matter of long-standing company policy, Humana does not comment on pending litigation,” said company spokesman Tom Noland.

Thompson, a Delray Beach doctor, was indicted early last year on health care fraud charges stemming from similar allegations. He had pleaded not guilty but last week indicated he would change his plea and was to appear Friday in federal court in Fort Lauderdale, according to court records.

– NPR

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