Amerigroup rejects pregnant women & high risk applicants & defrauds Medicare.

[DailyGrind51]

Aug 14, 2008 1:43 pm US/Central
"Amerigroup Settles Medicare Fraud Case For $225M
CHICAGO (STNG) ― Amerigroup Corp. has agreed to end its appeal of a $334 million federal court judgment and pay $225 million to resolve claims it defrauded the Illinois Medicaid program by refusing to enroll pregnant women and other high-risk patients.

The settlement with Amerigroup, based in Virginia Beach, Va., replaces the federal court judgment, but remains the largest-ever award in a federal health care fraud case in Illinois, according to a release from the U.S. Attorney's office.

From 2000-04, Amerigroup was paid $243 million by the United States and Illinois to operate a Medicaid managed care plan in the state to provide health care to low-income people. It was required by law to enroll all eligible beneficiaries, including pregnant women, but the suit alleged it violated this requirement, and avoided enrolling unhealthy patients, as well as pregnant women, who were more costly to treat and would have eroded profit margins, the release said.

In October 2006, a federal jury found Amerigroup Corp. and Amerigroup Illinois liable for systematic and extensive fraud in the Medicaid program, the release said. The jury awarded the United States and Illinois $48 million in damages, which was automatically tripled by statute to $144 million. In March 2007, U.S. District Judge Harry Leinenweber imposed additional civil penalties of $10,500 on each of 18,130 false claims, for a total of more than $190 million, increasing total liability to more than $334 million..." (more at link)

http://cbs2chicago.com/local/medicare.fraud.amerigroup.2.795216.html

[Triana]

1. healthcare should not be a profit-driven "industry"...

period.

[DailyGrind51]

2. Thank you!

The "free-market" is fine when it comes to competing brands of cars, beer, and peanut butter, but has no place in health-care, which, as Thom Hartmann frequently reminds us, is "part of the commons".

[miles 2 go]

3. How many of those unhealthy patients worsened or died

as a result? How many babies? Murder comes in many forms and should be treated as such.

[DCKit]

4. I think this judge has just handed us the answer to funding Medicare.

Within two years, resistance to universal health care should crumble.