Feds Join Two False Claims Act Suits Targeting UnitedHealth Medicare Advantage Billing

In February 2017, the U.S. Department of Justice (DOJ) filed a legal motion to intervene in a whistleblower complaint filed in 2009 that alleges UnitedHealth Group committed fraud by exaggerating health risks of its Medicare Advantage enrollees. On March 24, the DOJ filed a motion to intervene in another similar whistleblower complaint filed in 2011, and on March 27, the DOJ filed a court order to combine the two complaints.

The Centers for Medicare & Medicaid Services (CMS) pays Medicare Advantage organizations fixed monthly amounts for each enrollee. However, CMS will pay a higher amount for enrollees with multiple . . .