Healthcare Providers Settle $62M Medicare Fraud Allegations

Health care providers in Koreatown and Northridge have agreed to pay over $62 million to settle allegations of submitting false diagnosis codes to Medicare Advantage for increased payments. Seoul Medical Group and its subsidiary were implicated in violating the False Claims Act, with their former president settling for $1.76 million. Additionally, Renaissance Imaging Medical Associates has paid $2.35 million for conspiring in the false diagnoses. Federal prosecutors stated that between 2015 and 2021, false diagnoses for spinal conditions were submitted for patients who did not actually suffer from them.

The Justice Department emphasized the importance of accurate reporting in Medicare Advantage, a crucial program for seniors. The settlement reflects the government's commitment to combat false claims and protect taxpayer funds, as healthcare providers are expected to provide truthful information. The case was brought forward under whistleblower provisions of the False Claims Act by a former executive of the accused companies.