UnitedHealthcare sues Next Health over alleged kickback scheme: 7 things to know

Kelly Gooch -

UnitedHealthcare is accusing a Dallas-based laboratory network of a $100 million scheme involving kickbacks to physicians and other providers for overpriced and unnecessary drug and genetic tests, reports The Dallas Morning News.

Here are seven things to know.

1. The Minnetonka, Minn.-based insurer filed an 81-page lawsuit against Next Health Friday in Dallas federal court.

2. The lawsuit says Next Health allegedly committed the fraud between 2011 and 2016, according to the report.

3. Specifically, the lawsuit claims Next Health's sales consultants gave people $50 gift cards to urinate in cups at Whataburger bathrooms, the report states.

4. UnitedHealthcare said Next Health then performed unnecessary and expensive tests on the specimens under the appearance of a "wellness study," according to the report.

5. The insurer claims Next Health went after self-funded insurance plans offered by the Texas Employee Retirement System and other governmental entities in the state, reports The Dallas Morning News.

6. As a result of the alleged fraudulent activity, UnitedHealthcare contends it got hit with a $100 million tab, reports The Dallas Morning News.

7. In a prepared statement, Next Health expressed disappointment in United Healthcare's lawsuit, "as we have been negotiating with them to develop a new working agreement covering a number of operational and financial issues," according to the report.

"In our view, this is a matter for continued negotiation and not litigation, especially as the lawsuit misrepresents our actions, responsibilities and compliance standards. We remain confident that, acting in good faith, we can resolve this dispute quickly," Next Health said. "If necessary, Next Health will be fully prepared to defend our company and our practices in court."

 

Copyright © 2024 Becker's Healthcare. All Rights Reserved. Privacy Policy. Cookie Policy. Linking and Reprinting Policy.