National media: U.S. Attorney investigating Humana in Florida for Medicare/Medicaid practices
This is not a new story, but it could turn out to be an important one.
Bloomberg and other national media are reporting Louisville-based health insurer/health care provider Humana is under investigation for Medicare pay-for-play in Florida.
In a regulatory filing, Humana executives stated the U.S. Attorney’s Office in Miami requested documents and other information from Humana and its affiliates back in January.
The company stated yesterday its internal probe is continuing and involves “relationships” between some of its Florida employees and Medicare and Medicaid providers, the financial support of nonprofit or provider centers that enroll Medicare patients and “financial support” made to doctor practices. Humana Inc. (HUM), the second-biggest provider of private Medicare coverage, said the U.S. Justice Department is investigating its coding of medical claims from South Florida doctors and loans made to physician practices. Humana last year disclosed its own investigation into enrollment practices and loans to providers in its Medicare and Medicaid networks in Florida. The company also faces a whistle- blower lawsuit alleging its practices in that state violated a federal anti-kickback statue, according to the filing.
Humana earned 65 percent of its $37 billion in revenue last year from providing drug and medical benefits to Medicare members, the federal insurance program for the elderly and disabled. It got 2.6 percent of revenue from Medicaid, the joint state-federal program for the poor, according to Bloomberg.
Humana has had a bummer of a week, with shares falling about 8.1 percent Monday – the worst day in the past three years – after the company said its first-quarter profit dropped 21 percent, missing analyst estimates by a mile. Shares are trading at a six-month low of about $80 per share. The company is the largest corporation by revenue based in Louisville.