Here are five things to know about the case.
1. In Los Angeles on Monday, U.S. District Judge Michael Fitzgerald said the department sufficiently alleged UnitedHealth provided the government with inaccurate data about the health status of its Medicare Advantage beneficiaries.
2. However, Mr. Fitzgerald dismissed accusations UnitedHealth falsely attested to the data’s accuracy. The department’s key argument that the assurances affected CMS’ payment decisions for Medicare and Medicaid services wasn’t apparent, he said.
3. UnitedHealth rejected the Justice Department’s claims Tuesday and vowed to continue fighting them.
4. Last May, the Justice Department intervened in a whistle-blower lawsuit brought by Benjamin Poehling, former finance director of UnitedHealthcare Medicare and Retirement, who filed the case under seal in 2011. The lawsuit alleges UnitedHealth defrauded the Medicare program more than $1.14 billion between 2011 and 2014.
5. In October, a federal judge dismissed a separate but similar case against UnitedHealth. In that case, the judge ruled the federal government failed to claim CMS would not have made payments to UnitedHealth if it was aware of facts presented in the case.
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