HMO To Pay $4.8 million FCA Settlement

Abri Health Plan Inc., of Germantown Wisconsin and its parent company, Universal American Financial Corp., agreed to pay $4.8 million to the U.S. to resolve a suit brought under the qui tam provisions of the False Claims Act relating to its Medicare Part C coverage plan.

According to the whistleblowers, James Mlaker and J.D. Webb, Abri’s salespeople would mislead customers about the scope of the Medicare Part C coverage plan in violation of Medicare regulations and would even sign customers up for the plan without their consent.  Additionally, Abri allegedly paid doctors for referrals and paid customers to sign up for the Medicare Part C coverage plan.

As their share of the recovery, Mlaker and Webb will receive more than $900,000 of the $4.8 million.

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