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$320M Medi-Cal settlement reached with Calif. HMO

Posted: August 23, 2012 7:00 p.m.
Updated: August 23, 2012 7:00 p.m.

LOS ANGELES (AP) — California and federal officials have announced a $320 million settlement over allegations a Long Beach-based health plan received overpayments from Medi-Cal, the state's Medicaid program.

U.S. attorney spokesman Thom Mrozek says SCAN Health Plan, a health maintenance organization or HMO, submitted payments on Aug. 10 to state and federal authorities to resolve an investigation of services provided to its long term-care patients.

Mrozek says the settlement is the largest ever obtained from a single Medi-Cal provider.

Mrozek says the government alleged from 1985 to 2008 Medi-Cal made overpayments because the plan was reimbursed for long term-care patients who were cared for at home as if they were being cared for in nursing homes, where the costs are much higher.

Calls seeking comment from SCAN were not immediately returned Thursday.



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