U.S. Sues UnitedHealth Over Medicare Overpayments

(RTTNews) - For the second time in two weeks, the United States has filed a complaint against UnitedHealth Group Inc. (UNH) that alleged the company knowingly obtained inflated risk adjustment payments based on untruthful and inaccurate information about the health status of beneficiaries enrolled in UnitedHealth Group or UHG's Medicare Advantage Plans throughout the United States, the U.S. Justice Department announced today.

Today's action follows the government's filing of a complaint earlier this month in United States ex rel. Swoben v. Secure Horizons, a related action that also alleged that UHG submitted false claims for payment to the Medicare Program.

The risk adjustment payments are based on the health status of the beneficiary, which are reflected by diagnosis that receives from treating physicians and subsequently submits to Medicare for each beneficiary.