A Maryland-based firm, Aledade Inc., renowned for managing the largest independent network of primary care medical practices in the United States, is facing serious allegations of Medicare fraud. The accusations stem from a whistleblower lawsuit claiming that the company manipulated billing software to overstate patients’ medical conditions, resulting in substantial financial gains.
The civil suit, filed by Khushwinder Singh in federal court in Seattle in 2021 and unsealed in January this year, paints a troubling picture of fraudulent practices within Aledade. Singh, a former senior medical director at Aledade, alleges that the company’s billing apps and software were designed to artificially inflate patients’ diagnoses, leading to increased Medicare reimbursements.
According to the lawsuit, Aledade employed tactics such as conflating anxiety with depression and categorizing moderate alcohol consumption as substance abuse to generate additional revenue. These alleged practices, known as “upcoding,” could potentially amount to millions of dollars in improper payments from Medicare.
Singh claims that he was terminated from his position at Aledade after raising objections to these fraudulent activities. However, the company has vehemently denied the allegations, labeling the lawsuit as “totally baseless and meritless.”
Source: Whistleblower Alleges Medicare Fraud by Aledade, Leading US Primary Care Network / The UBJ.com