Menu
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…
Using an Outdated Schedule for Reimbursements
On April 13, 2004, the New York State Insurance Department and Health Net reached an agreement that stated that Health Net would “refund policyholders $4.99 million for claims and interest for medical services. Also, Health Net will create an appeals process for claims that had been partially or fully denied and will offer new appeals on certain emergency room claims that had been denied. The Department’s recent Report on Examination revealed that Health Net utilized an outdated schedule to determine certain reimbursements for out-of-network physicians and other medical providers between July 1999 and December 2002.” Along with the $4.99 million refund, Health Net paid a $500,000 fine.
- Misconduct Type
- Cost/Labor Mischarge
- Enforcement Agency
- State/Local
- Contracting Party
- None
- Court Type
- Civil
- Disposition
- Settlement
- Date of Settlement Agreement
- 4/13/2004