Evergreen Reporter

MMM Holdings, LLC has agreed to pay $15.2 million to settle allegations of violating the False Claims Act and the Anti-Kickback Statute, as announced by the United States Attorney for the District of Puerto Rico and the U.S. Department of Health and Human Services Office of Inspector General (HHS-OIG).

The settlement addresses claims that MMM implemented a gift card incentive program between January 2018 and December 2022, which allegedly led to violations of federal laws. The United States alleged that MMM distributed gift cards to administrative assistants to induce referrals or enrollments in their Medicare Advantage plan, resulting in premium payments amounting to $6,091,336.

As part of the resolution, MMM entered into a five-year Corporate Integrity Agreement with HHS-OIG. This agreement mandates procedures ensuring compliance with legal marketing practices and requires an Independent Review Organization to annually assess MMM's arrangements under this agreement.

United States Attorney W. Stephen Muldrow emphasized the importance of deterring healthcare fraud: "Investigating healthcare fraud remains a high priority in the Department of Justice... we appreciate MMM’s cooperation during the investigation." Naomi Gruchacz from HHS-OIG added, "Medicare Advantage plans that engage in improper financial arrangements undermine the integrity of the Medicare program."

Assistant U.S. Attorney Rafael J. López-Rivera led this case with support from HHS-OIG and FBI collaboration.

The settlement resolves civil claims without any admission or determination of liability by MMM.

For reporting waste or fraud in federal programs, contact details for HHS-OIG Hotline and FBI are provided.