CVS Subsidiary Oak Street Health Agrees to $60M Settlement in Medicare Kickback Violations
CVS Subsidiary Oak Street Health Agrees to $60M Settlement in Medicare Kickback Violations
The allegations center around Oak Street Health's Client Awareness Program, launched in 2020, which aimed to increase membership through third-party insurance agents.Wednesday, Oak Street Health, a subsidiary of CVS Health Inc (NYSE:CVS), agreed to settle for $60 million following allegations that it violated the False Claims Act.
週三，西維斯健康旗下的子公司橡樹街健康公司（NYSE:CVS）同意支付6000萬美元，以了結違反虛假索賠法的指控。
The claims involved paying kickbacks to third-party insurance agents to recruit seniors to its primary care clinics, a practice that led to false Medicare submissions.
這些指控涉及向第三方保險代理支付回扣，以招募老年人前往其初級保健診所，這種做法導致虛假的醫保申請。
Also Read: Pharmacy Chains Like CVS Health, Walgreens Boots Alliance Confront Shifting Consumer Habits And Profit Pressures.
另請閱讀：像西維斯健康、沃爾格林-聯合博姿這樣的藥店連鎖面臨消費習慣和利潤壓力的轉變。
The allegations center around Oak Street Health's Client Awareness Program, launched in 2020, which aimed to increase membership through third-party insurance agents.
這些指控圍繞着橡樹街健康公司於2020年推出的客戶意識計劃展開，該計劃旨在通過第三方保險代理增加會員數量。
These agents targeted seniors enrolled or eligible for Medicare Advantage (MA) plans, directing them toward Oak Street's services.
這些代理針對參加或有資格參加Medicare Advantage（MA）計劃的老年人，引導他們使用橡樹街的服務。
In exchange, agents received approximately $200 per referral, incentivizing them to prioritize financial gain over seniors' best interests.
作爲交換，代理每次推薦可獲得約200美元的報酬，這激勵他們優先考慮財務利益而不是老年人的最佳利益。
This behavior violated the Anti-Kickback Statute, which prohibits offering payment to induce patient referrals under federally funded programs like Medicare.
這種行爲違反了禁止向聯邦資助計劃（如Medicare）下的患者推薦提供報酬的《反回扣法》。
The U.S. Department of Justice (DOJ) claimed that Oak Street Health knowingly submitted false claims to Medicare between September 2020 and December 2022 due to these illegal kickbacks.
美國司法部（DOJ）聲稱，橡樹街健康公司知情地在2020年9月至2022年12月間向Medicare提交了虛假索賠，原因是這些非法的回扣。
"Health care providers that attempt to profit from kickbacks will be held accountable," said Principal Deputy Assistant Attorney General Brian M. Boynton, head of the Justice Department's Civil Division. "We are committed to rooting out illegal practices committed by Medicare Advantage providers, insurance agents and brokers that undermine the interests of federal health care programs and the patients they serve."
「試圖從回扣中獲利的醫療保健提供者將受到追責，」正義部民事部副助理部長布賴恩·M·博因頓表示。 「我們致力於查處醫療保險優勢提供者、保險代理人和經紀人所犯下的違法行爲，這些行爲損害了聯邦醫療保健計劃和服務於患者的利益。」
Additionally, the settlement resolves claims brought under the whistleblower provisions of the False Claims Act by Joseph Stinson. Stinson will receive $9.9 million as part of the settlement.
此外，此次和解還解決了根據《虛假索賠法》的內部告密者規定提出的索賠。斯廷森將在和解過程中獲得990萬美元。
Last week, Walgreens Boots Alliance Inc. (NASDAQ:WBA) agreed to pay $106.8 million to settle allegations that it submitted false claims to government healthcare programs, violating the False Claims Act and state regulations.
上週，沃爾格林-聯合博姿股份有限公司（NASDAQ：WBA）同意支付10680萬美元，以解決其向政府醫療保健計劃提交虛假索賠、違反虛假索賠法和州法規的指控。
Price Action: CVS stock is up 0.27% at $58.58 at the last check Thursday.
價格走勢：CVS股票在最後一次檢查時漲0.27%，至58.58美元。
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譯文內容由第三人軟體翻譯。