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.
More articles on healthcare industry lawsuits:
10 latest healthcare industry lawsuits, settlements
Physician gets 9 years for role in $20M fraud scheme
5 False Claims Act trends, cases that will fuel recoveries in 2016
Becker’s 3rd Annual Fall Chief Pharmacy Officer Summit is the top tier event that the people leading the future of pharmacy convene. This 3-day event is built specifically for Chief Pharmacy Officers and senior pharmacy leaders. The sessions examine the workforce, financial and clinical priorities shaping pharmacy today. Becker’s is where candid discussions flourish and new ideas thrive. Becker's 3rd Annual Fall Chief Pharmacy Officer Summit
