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The US Department of Justice has accused an insurance and a data mining company of fraud, according to NPR.

It adds that the civil complaint was filed by the DOJ against Independent Health Association, which operates two Medicare Advantage plans; DxID, a data mining company owned by an Independent Health subsidiary, but which shut down last month; and Betsy Gaffney, founder and CEO of DxID. The DOJ alleges that DxID reviewed patient records to uncover additional diagnoses that were then added to patients' records, sometimes a year after their visits. This, the allegations add, made patients look sicker than they were, led to additional diagnosis codes being submitted, and defrauded the government of millions of dollars.

In an email to NPR, Frank Sava, an Independent Health spokesperson, wrote that they are aware of the complaint and "will continue to defend ourselves vigorously against the allegations."

NPR adds that this complaint appears to be an extension of a 2012 whistleblower case filed by a former medical-coding employee at Group Health Cooperative, who alleged Group Health hired DxID, which then submitted millions of dollars in new disease claims. That case, according to NPR, was settled in 2020.

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