IBM pays $14.8 million to settle False Claims Act charges relating to Maryland Affordable Care Act exchange contract

by Ben Vernia | June 14th, 2019

On June 14, the Department of Justice announced that IBM had agreed to pay nearly $15 million to settle civil claims that the company … According to DOJ’s press release:

International Business Machines Corporation (IBM) and Cúram Software have agreed to pay $14.8 million to settle alleged violations of the False Claims Act arising from material misrepresentations to the State of Maryland during the Maryland Health Benefit Exchange (MHBE) contract award process for the development of Maryland’s Health Insurance Exchange (HIX) website and IT platform, the Department of Justice announced today.

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On Dec. 19, 2011, IBM completed its acquisition of Cúram Software Ltd (Cúram). That same day, a proposal was submitted to the State of Maryland to support the HIX, which was drafted in part by Cúram and included Cúram as a subcontractor for software and services. On Jan. 5, 2012, as part of the bid evaluation process and with IBM’s knowledge, Cúram participated in a presentation to the State of Maryland that illustrated Cúram software conducting eligibility determinations for health assistance coverage, calculating applicable tax credits, addressing changes in life events (e.g. changes in income), and illustrating the integration of Cúram’s software with another subcontractor’s health plan shopping software. On Feb. 22, 2012, the State, acting through MHBE, awarded the contract for development of Maryland’s HIX website and IT platform. Cúram-IBM served as a subcontractor on the project. Federal grants from the U.S. Department of Health and Human Services partially funded MHBE’s contract for the Maryland HIX.

The settlement covers the time period from Jan. 1, 2011, through May 31, 2014, and resolves allegations against Cúram-IBM regarding material misrepresentations made to the State of Maryland during the HIX contract procurement process, including misrepresentations regarding the development status of the Cúram for Health Care Reform software; the existing functionality of the Cúram software to meet the State’s technical requirements, such as addressing life events and calculating tax credits under the Patient Protection and Affordable Care Act; and the integration of Cúram software with other software needed to provide a properly functioning HIX website.  After repeated problems following the launch of the HIX website in October 2013, Maryland, acting through MHBE, terminated the contract and replaced the HIX website and IT platform, including the Cúram software.

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The case apparently arose from a government investigation, not from a whistleblower’s lawsuit.

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