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Federal Contractor Misconduct Database (FCMD)

The federal government routinely awards contracts to companies with histories of misconduct, including contract fraud and other violations. POGO believes that providing this website will help to improve contracting decisions and increase public knowledge of how the government spends billions of taxpayer dollars each year. Read more…

Medicare Advantage Compliance Audit

A U.S. Department of Health and Human Services (HHS) inspector general (IG) audit of Humana’s Medicare Advantage contract found that Humana did not submit some diagnosis codes to the Centers for Medicare and Medicaid Services (CMS) in accordance with federal requirements, resulting in at least $197.7 million in overpayments for 2015. The IG found these errors occurred because Humana’s policies and procedures to prevent, detect, and correct noncompliance with CMS’s program requirements were not always effective. The IG recommended that Humana refund the overpayments and enhance its policies and procedures to prevent, detect, and correct noncompliance with federal requirements for diagnosis codes that are used to calculate risk-adjusted payments.

Misconduct Type
Poor Contract Performance
Enforcement Agency
Health and Human Services
Contracting Party
Health and Human Services
Court Type
N/A
Disposition
Investigative Finding
Date of Report
4/19/2021
Contractors Involved Penalty
Total
Humana $0
Further Information Released
Full Report 4/19/2021
Report Summary 4/19/2021

Federal Contractor Misconduct Database