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The Free Financial Advisor

Amanda Blankenship

Florida Health System Agrees to $541.5 Million Settlement Over Medicare Advantage Diagnosis Codes

Medicare Advantage Medicare DOJ Florida CMS the Justice Department UnitedHealthcare

Medicare Advantage diagnosis codes — A $541.5 million federal settlement involving The Villages Health System highlights how diagnosis codes can affect Medicare Advantage payments. The Justice Department says the settlement resolves allegations and does not constitute a determination of liability. Anatoliy Cherkas/Shutterstock

A Florida healthcare provider has agreed to a massive $541.5 million settlement with the federal government over allegations that unsupported diagnosis codes helped drive up Medicare Advantage payments.

The Villages Health System LLC (TVH), headquartered in The Villages, Florida, agreed to resolve False Claims Act allegations involving diagnosis codes submitted between 2020 and 2024, the U.S. Department of Justice announced August 26.

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