Morning Briefing
Summaries of health policy coverage from major news organizations
Whistleblower Case Alleging UnitedHealth Defrauded Medicare Program Allowed To Move Forward
Reuters: U.S. Can Sue UnitedHealth In $1 Billion Medicare Case, Judge Rules
A federal judge has ruled the U.S. Justice Department can move forward with a lawsuit claiming UnitedHealth Group Inc wrongly retained more than $1 billion from the government healthcare program Medicare. U.S. District Judge Michael Fitzgerald in Los Angeles on Monday ruled that the department had sufficiently alleged UnitedHealth submitted invalid diagnostic data related to the health status of patients enrolled in Medicare Advantage plans. (Raymond, 2/13)
The Star Tribune: Judge Allows UnitedHealth Medicare Fraud Case To Proceed
The ruling came in a case brought by a former UnitedHealth Group employee in Minnesota alleging the company submitted false information about patient conditions to collect higher payments. It was unsealed a year ago after the federal government joined the case. They alleged that UnitedHealth Group engaged in “one-sided” reviews of patient charts, looking for ways to boost payments without correcting erroneous data that would lower reimbursement. In an order Monday, U.S. District Judge Michael Fitzgerald dismissed claims related to Medicare payments before 2009, and he said three of six claims would be dismissed unless the government amended its filing. But Fitzgerald denied UnitedHealth Group’s motion to dismiss an allegation that the company avoided an obligation to refund money to the government, as well as related claims for unjust enrichment and payment by mistake. In the order, he gave the government until Feb. 26 to amend its complaint. (Snowbeck, 2/13)
