Second Largest Medicare Advantage FCA Settlement of All Time

The useful part

Department of Justice announced the settlement on August 26, 2026, the day after the U.S. Attorney's Office for the Middle District of Florida, and HHS-OIG all participated in resolving the matter. Medicare Advantage enrollment has grown steadily for years and now covers more than half of all Medicare beneficiaries, making the accuracy of risk-adjustment data a central fiscal concern for the program.

How it works

• Inflated diagnosis coding can quietly drain billions of Medicare dollars annually without triggering the more visible claims-based red flags common in traditional fee-for-service fraud.