The U.S. Justice Department has joined a whistleblower lawsuit against Martin's Point Health Care and five other health plans across the U.S. for allegedly defrauding the Department of Defense. The lawsuit says they were paid inflated rates under a health plan that provides care for acting and retired military service personnel and their families.
Maine-based Martin's Point, Maryland-based Johns Hopkins Medical Services Corporation, St. Vincent’s Catholic Medical Centers of New York, Brighton Marine Health Center of Massachusetts, Pacific Medical Center in Washington state, and CHRISTUS Health in Texas are the only providers in the country that offer care under the Uniformed Services Family Health Plan. The complaint alleges that between 2008-2012, they collectively received more than $300 million in overpayments due to calculation errors.
After the errors were discovered, Martin's Point and the other providers allegedly never told the federal government or paid the money back.
The lawsuit was initially filed in 2016 by two whistleblowers connected with Martin's Point. Jane Rollinson served as interim chief financial officer and Daniel Gregorie was a consultant and member of the board of trustees.
Martin's Point "vigorously disputes" the allegations. Spokesperson Steve Amendo says says the rates were mutually agreed upon more than a decade ago and the organization "is confident that the evidence in this case will show that Martin’s Point met its obligations under the USFHP contract and did not receive an overpayment."
Last year, Martin's Point paid $22 million to settle a lawsuit that alleged it submitted false Medicare Advantage claims to receive higher reimbursements.
