Humana fined for not reporting Medicaid fraud

Aug 19, 2011

The following article was published in the Bradenton News on August 19, 2011:

Humana fined for not reporting Medicaid fraud

State officials in Florida say they’ve fined health insurance giant Humana Inc. $3.4 million for failing to promptly report Medicaid fraud or abuse.

According to the South Florida Sun Sentinel (, health regulators sent two letters last week to Humana’s Miramar office, saying the company didn’t disclose what it knew about suspected fraud and abuse by Medicaid providers or recipients, going back as far as September 2009.

Humana and its CarePlus subsidiary make up Florida’s largest HMO with 568,000 members – most of them in Medicare.

It’s unclear if the fine is related to an internal investigation the Kentucky-based company is making in South Florida, which the company says it has disclosed to federal prosecutors.

A Humana spokesman says the company is reviewing the letters from the state and will determine its next steps after that.