U.S. Intervenes In False Claims Act Lawsuit Against UnitedHealth

(RTTNews) - The United States has intervened and filed a complaint in a lawsuit against UnitedHealth Group Inc. (UNH) or UHG that alleged UHG obtained inflated risk adjustment payments based on untruthful and inaccurate information about the health status of beneficiaries enrolled in UHG's largest Medicare Advantage Plan, UHC of California, the U.S. Justice Department announced today.

The action follows the government's intervention in February of this year in United State ex rel. Poehling v. UnitedHealth Group. Inc., a related lawsuit in the Central District of California that also alleges that UHG defrauded the Medicare Program. government is scheduled to file a complaint in that matter no later than May 16.

The complaint filed by the United States alleged that UHG knowingly disregarded information about beneficiaries' medical conditions, which increased the payments UHG received from Medicare.

The lawsuit contends that UHG funded chart reviews conducted by HealthCare Partners (HCP), one of the largest providers of services to UHG beneficiaries in California, to increase the risk adjustment payments received from the Medicare Program for beneficiaries under HCP's care. However, UHG allegedly ignored information from these chart reviews about invalid diagnoses and thus avoided repaying Medicare monies to which it was not entitled.

The claims asserted against UHG are allegations only, and there has been no determination of liability.