Humana-owned Villages Health agrees to $542M settlement for Medicare overbilling

The Villages Health, a practice owned by Humana, will pay $542 million to resolve allegations it submitted false claims to Medicare. The Department of Justice claims the Florida-based primary care group billed for evaluation and management services that were not medically necessary or not provided. The settlement targets alleged upcoding and improper documentation practices. This action signals ongoing DOJ scrutiny of corporate-owned medical groups and their billing patterns. It follows a recent $2.4M settlement with Monogram Health. Medicare Advantage plans face increasing enforcement.