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Indian-origin executive to pay $750,000 to resolve fraud allegations

Indian-origin executive to pay $750,000 to resolve fraud allegations
U.S. one-hundred dollar bills are seen in this photo illustration at a bank in Seoul August 2, 2013. Picture taken August 2, 2013. South Korea's foreign reserves jumped to a record high in July, the central bank said on August 5, 2013, appearing to support traders' suspicions of dollar-buying intervention by currency authorities last month. The reserves stood at $329.71 billion at the end of July, up $3.27 billion from June, the Bank of Korea said in a statement, attributing the rise to management gains and the appreciation of the euro in July, which the Bank of Korea said was up 1.8 percent against the dollar last month. REUTERS/Kim Hong-Ji (SOUTH KOREA - Tags: BUSINESS)

New york: An Indian-origin executive by a Florida-based provider of managed care services has agreed to pay $750,000 to resolve his alleged role in an extensive fraud scheme perpetrated by the company.

Siddhartha Pagidipati, the former Chief Operating Officer (COO) of Freedom Health, has agreed to pay $750,000 to resolve his alleged role in the scheme, the Justice Department announced.

Freedom Health and its related corporate entities also agreed to pay $32.5 million to resolve allegations that they violated the ‘False Claims Act’ by engaging in illegal schemes to maximise their payment from the government in connection with their Medicare Advantage plans.

The government alleged that Freedom Health submitted or caused others to submit unsupported diagnosis codes to a federal health agency which resulted in inflated reimbursements from 2008 to 2013 in connection with two of their Medicare Advantage plans operating in Florida.

It also alleged that Freedom Health made material misrepresentations to the agency regarding the scope and content of its network of providers (physicians, specialists and hospitals) in its application. The government’s settlement with Pagidipati resolves his alleged role in this latter scheme.

“When entering into agreements with managed care providers, the government requests information from those providers to ensure that patients are afforded the appropriate level of care,” said Acting Assistant Attorney General Chad Readler of the Justice Department’s Civil Division.

“Today’s result sends a clear message to the managed care industry that the United States will hold managed care plan providers responsible when they fail to provide truthful information.”