UnitedHealth, dialysis provider settle fraud lawsuits for $32M

UnitedHealthcare, the health insurance arm of UnitedHealth Group, and American Renal Associates Holdings agreed to settle fraud allegations UnitedHealthcare brought against the dialysis provider in 2016, the companies said July 9.

In 2016, UnitedHealthcare filed suit against American Renal Associates, alleging the Beverly, Mass.-based dialysis chain engaged in a "fraudulent and illegal scheme" to maximize its own profits. UnitedHealthcare claimed ARA convinced patients to enroll in plans UnitedHealthcare sold on the ACA exchanges instead of Medicare and/or Medicaid coverage. The insurer accused ARA of connecting these patients with the American Kidney Fund to help pay their insurance premiums, according to The Wall Street Journal.

ARA and UnitedHealthcare will negotiate terms of a definitive $32 million settlement by Aug. 1. In conjunction with the agreement, ARA, which operates 228 dialysis clinics nationwide, will enter a three-year network agreement with UnitedHealthcare. The contract is effective Aug. 1, and will include value-based contracting terms.

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