SCAN Health Plan’s $322 Million Settlement Part of Medical/Medicaid Fraud Recovery Against HMO

Aug. 24, 2012 - PRLog -- SCAN Health Plan, a Long Beach, California-based HMO that serves more than 130,000 members in California and Arizona, has agreed to pay the nation’s largest Medicaid fraud recovery against an HMO, whistleblower attorney William K. Hanagami announced today.
   
Southern California attorneys Hanagami and Abram J. Zinberg represent whistleblower James Swoben who sparked the state and federal investigations that ended with today’s settlement, requiring SCAN to pay California and the federal government $322 million, $318.2 million of which is for Medi-Cal (California’s Medicaid program) fraud.

“Today is a great day for the taxpayers,” said Hanagami. “We are pleased to have filed the lawsuit against SCAN and participated in the investigation that resulted in the largest Medi-Cal fraud recovery in California history, and the nation’s largest Medicaid fraud recovery against an HMO. With severe cutbacks to the Medi-Cal program, this recovery could not come at a more opportune time for the people of California.”

“The taxpayers owe a debt of gratitude to our client, Jim Swoben.  SCAN retaliated against him after he complained to management that SCAN was engaging in a fraudulent audit practice that resulted in excessive payments by Medicare,” said Zinberg.  “Jim then met with State Senator Alan Lowenthal and expressed his concern that SCAN was also concealing key financial and healthcare information from Medi-Cal and receiving excessive Medi-Cal payments, and insisted that the State Controller’s office conduct a special audit.  As a result, the State Controller’s office conducted an investigation that validated Jim’s concerns.”

“Mr. Swoben wishes to thank State Controller John Chiang, State Senators Alan Lowenthal and Elaine Alquist, and their respective staffs for their assistance and efforts to safeguard the public trust,” said Hanagami.  “We must remain vigilant in our efforts to protect the taxpayers’ money.  As large as this recovery is, we believe that it only represents the tip of the iceberg.”

“We will continue to root out healthcare fraud with the assistance of whistleblowers like Jim Swoben,” said Zinberg.  “He encourages others in the healthcare industry, like himself, to do the right thing by coming forward and identifying frauds committed against the government.”

Hanagami and Zinberg filed the whistleblower lawsuit on behalf of the federal and California governments against SCAN, which resulted in the record-setting recovery.  The case was filed in the United States District Court in Los Angeles as case number CV09-5013 JFW (JEMx), entitled U.S. ex rel Swoben v. SCAN Health Plan.

Contacts:

William K. Hanagami         Abram J. Zinberg
The Hanagami Law Firm      (714) 374-9802
(818) 716-8570         AbramZinberg@gmail.com
BillHanagami@esquire.la