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DOJ Secures ACA Fraud Guilty Plea, Says Task Force Recovered $500 Million in Three Cases

The moves signal a stepped-up drive to recover taxpayer funds lost to health and COVID-era scams.

Overview

  • AP of South Florida pleaded guilty in an Affordable Care Act enrollment scheme that drew $141.5 million in improper subsidies and agreed to pay a $27.6 million criminal fine.
  • Prosecutors said the brokerage targeted low-income people with cash or gift cards and submitted false details that caused some to lose Medicaid coverage.
  • AssuredPartners, the former parent of the Florida brokerage, reached a separate civil settlement to resolve False Claims Act claims and was not charged in the criminal case, while current owner Arthur J. Gallagher said it never owned the Florida unit.
  • In a related California case, three defendants admitted to a Medicaid pharmacy scheme tied to $269.1 million in false claims, and authorities seized about $126.5 million in assets.
  • In Nevada, a defendant received a 54-month sentence for a COVID-19 tax credit scheme, and the Justice Department said the three cases together produced about $500 million in recoveries under the Task Force to Eliminate Fraud.