A federal court ordered Humana to pay more than $32 million in attorneys’ fees, costs and interest following the resolution of a False Claims Act case in 2024 over the company’s Medicare Part D bids.
In a Sept. 19 order, the U.S. District Court for the Western District of Kentucky directed Humana to pay $27.9 million in attorneys’ fees and $2.7 million in costs and expenses, plus post-judgment interest accruing since August 2024. The payment, totaling $32.2 million, was due Sept. 24.
The fee award stems from a lawsuit first filed in 2016 by a former Humana actuary, who alleged the company submitted fraudulent bids to CMS for its Walmart Part D prescription drug plan between 2011 and 2017. According to the complaint, Humana told CMS it would pay 75% of drug costs for members while internally estimating it would cover as little as 64.5%, leaving beneficiaries to pay the difference.
Humana agreed in 2024 to pay $90 million to settle the allegations, the first settlement of its kind to resolve claims of Part D contracting fraud, according to the law firm representing the whistleblower. The Justice Department declined to intervene in the case. The latest fee award is in addition to the settlement amount already reached.
“Humana firmly believes that the actuarial assumptions in its prescription drug plan were reasonable and in full compliance with all laws and regulatory requirements, and that the plaintiff’s claims in the case are without merit,” a spokesperson told Becker’s. “After a thorough investigation into the allegations, the US Department of Justice chose not to intervene in the case. While we are confident in our position and expected to prevail at trial, we made the decision to enter into a settlement agreement without admitting any wrongdoing to avoid the uncertainty, distraction, inconvenience, and expense of a lengthy jury trial.”
