HG Doctors Exposes Humana's Misconduct, Calls for Immediate Action to Protect Patients

Hernando Giraldo MD, Inc.has filed a motion for injunctive relief against Humana Inc., exposing a series of alleged unethical practices that jeopardize patient care and community trust.

HG Doctors Exposes Humana's Misconduct, Calls for Immediate Action to Protect Patients

BROWARD COUNTY, Fla., Jan. 23, 2025 /PRNewswire-PRWeb/ -- Hernando Giraldo MD, Inc., d/b/a HG Doctors, a trusted healthcare provider since 1979 and serving thousands of patients across South Florida, has filed a motion for injunctive relief against Humana Inc., exposing a series of alleged unethical practices that jeopardize patient care and community trust. HG Doctors facilities include Delray Medical & Dental, Coral Springs Medical & Dental, and Hallandale Medical Center.

Allegations outlined in a declaration filed by Randy Kirshbaum, COO of HG Doctors, reveal a disturbing pattern of misconduct, including price gouging Medicare Advantage members, data manipulation, overstating medical expenses, unjust termination of critical agreements, and predatory practices and conflicts of interest.

According to the lawsuit, Humana's actions threaten the continuity of care for thousands of Medicare Advantage patients, including the elderly and disabled, and disrupt long-standing physician-patient relationships. "The harm caused by Humana's decisions is immeasurable," said Randy Kirshbaum in his declaration. "These actions not only undermine trust but also jeopardize the lives and livelihoods of vulnerable populations and dedicated healthcare professionals" Randy Kirshbaum noted in his declaration.

Key Allegations Against Humana according to the lawsuit:

1.Price Gouging of Medicare Advantage Members: Humana allegedly overcharged its Medicare Advantage members for basic over-the-counter products through its CenterWell Pharmacy, pricing items significantly higher than other retailers.

2.Overstating Medical Expenses: Humana improperly inflated medical expenses to be incurred by HG Doctors including issuing $400,000 worth of "flex cards" to patients that permitted patients to purchase anything, (including dog food), while allocating these expenses as a healthcare expense.

3.Data Manipulation: Humana allegedly delayed and manipulated claims data, resulting in denied claims and revenue losses for HG Doctors, while overstating medical expenses and restricting access to necessary networks.

4.Breach of Contract: Humana issued a notice of termination of its agreements with HG Doctors, effectively leaving patients without critical care options. The termination was reportedly part of a scheme to facilitate Conviva's acquisition of HG Doctors at a reduced price.

5.Deceptive Practices: Humana allegedly delayed notifying Medicare beneficiaries of the termination until after the Open Enrollment period, leaving patients without the opportunity to make informed decisions about their care.

IMPACT ON PATIENTS AND PROVIDERS

According to the lawsuit, Humana's actions would sever trusted physician-patient relationships and disrupt continuity of care for thousands of vulnerable individuals, many of whom suffer from chronic conditions or disabilities. Patients face the risk of delayed treatments, increased medical expenses, and compromised health outcomes.

"These decisions are not about healthcare—they are about corporate greed," said Randy Kirshbaum, COO of HG Doctors. "We are fighting to ensure that our patients—many of whom have been with us for over a decade—are not abandoned or forced to navigate an unfamiliar system during a critical time in their lives."

A CALL FOR ACCOUNTABILITY

HG Doctors is committed to protecting its patients, physicians, and the community from these harmful practices. The motion for injunctive relief demands that Humana honor its contractual obligations, comply with federal regulations, and prioritize patient welfare over profit.

For updates and additional information, please contact HG Doctors Media Relations at [email protected]. 

ABOUT HG DOCTORS

Founded in 1979, HG Doctors has been a pillar of the South Florida healthcare community, offering primary care, dental, behavioral health, and wellness programs through its senior activity centers. Its facilities provide essential services to patients of all types including the underserved and vulnerable populations, fostering long-term relationships built on trust and excellence.

Media Contact

Media Relations, HG Doctors, 1 954-362-8677, [email protected], www.hgdoctors.com 

SOURCE HG Doctors