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The government awards contracts to companies with histories of misconduct such as contract fraud and environmental, ethics, and labor violations. In the absence of a centralized federal database listing instances of misconduct, the Project On Government Oversight (POGO) is providing such data. We believe that it will lead to improved contracting decisions and public access to information about how the government spends hundreds of billions of taxpayer money each year on goods and services. Report an instance of misconduct »

Humana

Failing to Promptly Report Medicaid Fraud or Abuse

Date: 08/09/2011 (Date of AHCA Letters)

Misconduct Type: Other

Enforcement Agency: State/Local

Contracting Party: None

Court Type: Administrative

Amount: $3,360,000

Disposition: Fine

Synopsis: The Florida Agency for Health Care Administration fined Humana Medical Plan $3.4 million for violating a state law requiring the prompt reporting of Medicaid fraud or abuse. The fines included $2.7 million, at a rate of $1,000 each day per violation, for not disclosing the alleged fraud or abuse within 15 days, as required under the state’s HMO regulations. The second fine of $660,400, at a rate of $200 a day, was for violating the terms of its HMO contract with the state. The agency sent Humana two letters accusing the company of failing to disclose information it knew about suspected fraud and abuse by Medicaid providers dating back to September 2009. The state is reportedly investigating possible improper loans or financial assistance made by Humana to Florida providers and improper relationships among providers and company officials.