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Agilon Health Inserts New Language Regarding Illegal Kickbacks
Healthcare services provider also acknowledges control deficiency related to the accuracy of revenue recognition.
March 15, 2023
Agilon Health (AGL), a healthcare services provider to seniors with Medicare Advantage plans, inserted new language in its latest annual report outlining the consequences of violating federal anti-kickback statutes. In addition to customary warnings regarding kickbacks in return for patient referrals, Agilon included the following:

“Kickbacks undermine the integrity of federal healthcare programs by tainting medical decision-making, increasing healthcare costs and negatively impacting competition.”

Additionally, Agilon added to its customary warning related to the possibility of being audited by payors and regulatory bodies. The company inserted new language citing the potential for government required plans aimed at correcting deficient practices:

“We may be subject to regulatory inquiries and corrective action plans…”

Separately, Agilon also revealed multiple control deficiencies, including problems related to its revenue and accounts receivable process:

“...which includes the ineffective design and operation of process level controls that addressed the completeness and accuracy of key financial and non-financial data utilized in the recognition of revenue and the Company did not retain sufficient contemporaneous documentation to demonstrate the operation of review controls over the various components of revenue at a sufficient level of precision.”

The company’s auditor Ernst & Young flagged Agilon’s estimation of “Medicare Advantage risk adjustment revenue” as a critical audit matter.
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