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The government alleges that company employees, during the period from 1991
through 1998, tampered with and altered Medicare files and claims information, and
hung up on customer service phone calls, in an effort to improve scores on Medicare
evaluations of Medicare operations in Kentucky administered by AdminaStar
Federal. AdminaStar Federal had disclosed certain of the suspected wrongdoing to
the Department of Justice and Department of Health and Human Services Office of
Inspector General.
"The prosecution of this and similar actions reflects the Department's continuing
commitment to ensuring that Medicare contractors meet their responsibilities to the
federal healthcare program," said Assistant Attorney General Peter D. Keisler.
The settlement resolves two qui tam, or whistleblower, suits brought against
AdminaStar under the False Claims Act. Under the act, private persons, known as
relators, may bring suit on behalf of the United States alleging fraud against the
government and, in an appropriate case, receive a share of the proceeds.
"This settlement reinforces the strong commitment that the Centers for Medicare &
Medicaid Services (CMS) and the federal government have to ensuring that
Medicare contractors properly perform their contractual obligations on behalf of
Medicare beneficiaries," said Mark McClellan, M.D. PhD., CMS Administrator.
The Department of Health and Human Services Office of the Inspector General
investigated the matter. The cases are entitled United States ex rel. Calabrese v.
AdminaStar Federal, et al., (W.D. Ky.) and United States ex rel. Moore and Scott v.
AdminaStar Federal, et al., (W.D. Ky.).
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05-492