Florida is a hot state, but it’s also been named a Hot State for healthcare fraud by several agencies. Two of the most common questions that we’re asked here at Advize Health are: 1) What do you do, and 2) Why are you located in Florida? Our responses to both questions are heavily rooted in Florida’s designation as a hot state. Despite our multiple lines of service, Advize began as a medical record audit and advisory firm – and we still are. Being headquartered in Florida means that we’re at the center of the action.
Take for example, yesterday’s news about a Tampa-based Medicare Advantage payer who settled on allegations that it violated the False Claims Act for nearly $32 million dollars.
Freedom Health was flagged by the United States Justice Department for [allegedly] illegally submitting unsupported diagnosis codes to CMS through two of its plans in order increase reimbursements rates. The Justice Department also claimed that Freedom Health was dishonest about the work scopes and their network of providers. This suit was conceived after a whistleblower tipped off the federal government.
This kind of activity is common in Florida, with the FL healthcare market being subjected to fraud, waste, and abuse regularly. We endure the heat to help payers, providers, and the government fight healthcare fraud.