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NEW YORK – The US Attorney for the Southern District of New York announced Friday the filing of a civil fraud lawsuit against insurer Anthem for allegedly falsely certifying diagnosis data submitted to the Centers for Medicare and Medicaid Services. 

Under Medicare Part C, also known as Medicare Advantage, Anthem is required to submit diagnosis data to CMS, which the agency then uses to calculate a risk score for each beneficiary that determines the payment Anthem receives from CMS for covering that patient.

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