Humana Medicare Advantage FCA Suit Has Legs, Judge Says

By Jeff Overley (February 28, 2017, 8:12 PM EST) -- A Florida federal magistrate judge on Monday recommended keeping alive a closely watched False Claims Act suit accusing Humana Inc. of ignoring suspicious Medicare Advantage billing, concluding that a jury could find the whistleblower's allegations credible.

U.S. Magistrate Judge John J. O'Sullivan recommended that Humana be denied summary judgment. His 31-page report said that evidence from whistleblower Olivia Graves is sufficient to suggest that Humana may have recklessly disregarded false billing by Plaza Medical Centers Corp. The evidence also indicates that Humana may have disregarded its own obligation to return overpayments, he said.

Although Humana had argued that the existence of...

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