Company Admits to Fraudulently Enrolling Beneficiaries and Identity Theft

AI

Troy Health Inc., a North Carolina-based provider of Medicare Advantage (MA), Medicare Part D, and Dual Eligible Special Needs Plans, has entered into a non-prosecution agreement with the Department of Justice to resolve a criminal investigation into a health care fraud and identity theft scheme involving the use of artificial intelligence and automation software to illegally obtain Medicare beneficiary information and fraudulently enroll beneficiaries into its MA plans. An acting assistant attorney general said that Troy told low-income beneficiaries it would use new technologies to improve health outcomes but instead misused patient data to enroll beneficiaries in its MA plan without their consent. Read a Department of Justice press release.

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