DOJ abandons most of lawsuit accusing UnitedHealth of Medicare fraud

The Justice Department cast aside much of a False Claims Act lawsuit alleging UnitedHealth Group used incorrect risk scores to inflate Medicare Advantage payments, according to Law 360.

The DOJ's decision marked the department's second loss in False Claims Act litigation against UnitedHealth. In October 2017, a federal judge rejected a lawsuit the DOJ filed against the insurer alleging UnitedHealth inflated government reimbursement by submitting information that made Medicare Advantage members appear sicker than they were.

The DOJ's Feb. 26 decision comes about two weeks after a California federal judge determined the DOJ could move forward with the lawsuit, with some exceptions. 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, but dismissed accusations UnitedHealth falsely attested to the data's accuracy. 

More articles on payer issues:
35.8% of Americans would use an Amazon health insurance plan
Aetna CEO: CVS deal will open '10,000 new front doors to the healthcare system'
Anthem cancels 25% cuts on some same-day services: 3 things to know

© Copyright ASC COMMUNICATIONS 2020. Interested in LINKING to or REPRINTING this content? View our policies by clicking here.