Martin’s Point, a nonprofit that provides primary care in southern Maine and New Hampshire and also enrolls about 60,000 patients in Medicare Advantage insurance plans, will pay more than $22 million to settle a case brought by the U.S. Justice Department alleging that Martin’s Point knowingly tried to boost reimbursements for Medicare Advantage enrollees through fraudulent billing practices, according to a Justice Department press release. The settlement is the largest of its kind in Maine history.
Medicare Advantage is a program that allows private corporations to offer plans to Medicare beneficiaries, paid for by Medicare funds. These private corporations, both for-profit and nonprofit, often reap substantial revenue and are under increasing scrutiny for fraudulent billing practices that cost Medicare–and taxpayers–billions of dollars.
The Portland Press Herald, Bangor Daily News, Maine Public, and other local and national media outlets have reported on the story.
Learn more from the Kitchen Table Campaign on Medicare (Dis)Advantage from Physicians for a National Health Program.