April 21, 2004 Highmark Inc.

Highmark Inc., an insurance company headquartered in Pittsburgh, will pay $1.5 Million Dollars to settle potential civil claims under the False Claims Act. The settlement resolves allegations that the employees of the company’s Veritus division, a Medicare contractor, tampered with and altered Medicare files and claims in an effort to improve scores on Medicare evaluations of the division’s performance during the period from 1992 through 1994.

In September 1988, Highmark paid $38.5 Million Dollars to settle claims that its corporate predecessor, Pennsylvania Blue Shield, violated the False Claims Act by obstructing Medicare audits of the company’s performance as a federal health care program contractor,  failing to properly process claims or recover overpayments, and also failing to properly screen Medicare claims before payment.

See U.S. Dept of Justice Press Release 4/21/04

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