Independence Blue Cross statement about U.S. Department of Justice settlement

Independence Blue Cross has entered into an agreement with the U.S. Department of Justice to resolve a False Claims Act matter involving certain Medicare Advantage risk adjustment documentation and submission practices during the period from 2016 through 2020. The agreement resolves the litigation and includes no admission of wrongdoing or liability. We chose to resolve the matter to avoid the delay, uncertainty, expense, and distraction of prolonged litigation.

Many major health plans have faced similar government scrutiny regarding Medicare Advantage risk adjustment requirements and practices, reflecting industry-wide challenges in the application of these standards. This matter was not about the quality of care our members received. It involved differing views regarding certain documentation and reporting requirements under the Medicare Advantage risk adjustment program.

We remain steadfast in our mission to enhance the health and well-being of the people and communities we serve.