The Justice Department has agreed to accept a $975,000 payment to resolve an investigation of provider compensation practices at a carrier that participated in the Federal Employees Health Benefits Program.
RightChoice Managed Care Inc., St. Louis, now a unit of WellPoint Inc., Indianapolis, is making the settlement payment in connection with allegations that it violated the False Claims Act while administering health coverage for federal employees and dependents in Missouri.
The carrier paid doctors higher rates for treating FEHB members than other health plans were paying, federal officials say.
"The agreement does not mean that any of our operational practices were improper," says Deborah Wiethop, a spokesman for a WellPoint subsidiary in Missouri. "RightChoice maintains that the physician fees at issue were reasonable and competitive with fees paid by other health plans in the same market and that it operated in full compliance with federal regulation and OPM guidance… The settlement agreement includes that assertion."
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