She's reporting live from New York.

Good morning, everyone.

I'm here to talk about a recent fourteen point one million dollar False Claims Act settlement against Complete Health Partners Holdings for alleged Medicare Advantage risk adjustment fraud.

The settlement is the result of a case that was originally brought by a whistleblower, and Complete Health is a management services organization that operates provider groups in Florida, Alabama, and Colorado.

Uh, everything I'm about to describe is an allegation only, um, so keep that in mind.

But the settlement alleges that Complete Health directed doctors to add high-value risk adjusting codes to patient records.

And listeners will know that the way Medicare Advantage works is that CMS pays Medicare Advantage organizations, uh, to insure each patient, and the amount that they pay varies based on risk.