Karen Clark, an investigator who worked for OptumHealth, brought the lawsuit under the qui tam provisions of the False Claims Act. She claims OptumHealth ignored complaints about behavioral health companies billing Medicaid for services that were never provided or were not medically necessary. Ms. Clark also alleges OptumHealth looked the other way when behavioral health companies billed under the wrong codes to get higher reimbursements.
Ms. Clark filed her lawsuit in 2013, and it was recently unsealed with the government decided not to intervene in the case, according to the report.
The whistle-blower lawsuit was filed against UnitedHealth Group, UnitedHealthcare, United Behavioral Health and OptumHealth New Mexico.
An OptumHealth spokesman did not return The New Mexican’s request for comment.
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