Attorney General drops Medicare Advantage lawsuit against UnitedHealth
Court found no proof that UnitedHealth officers signed off on Medicare Advantage data they knew to be false.
The United States Attorney's Office has dropped a lawsuit against UnitedHealth Group a week after a judge dismissed the case.
The Department of Justice had claimed that UnitedHealth Group and some of its subsidiaries had defrauded Medicare out of hundreds of millions in risk adjustment payments.
[Also: DOJ joins whistleblower lawsuit against UnitedHealth Group, WellMed]
At issue were allegations that UnitedHealth improperly inflated risk scores for Medicare Advantage and Part D prescription drug payments by submitting diagnosis codes that were not supported by patients' medical records.
The case was originally brought by whistleblower James Swoben, a former employee of Senior Care Action Network Plan and a risk adjustment consultant, according to Reuters.
In May, the DOJ intervened.
[Also: Feds allege UnitedHealth Group doctored patient records, overbilled Medicare by a $1 billion]
Court records show the case was dismissed in U.S. District Court in California on Oct. 13.
A week earlier, U.S. District Judge John Walter in Los Angeles ruled the lawsuit failed to identify any UnitedHealth officers who signed documents vouching for data submitted to MA programs, or to claim that they knew they were signing off on false information, according to Reuters.
But a second lawsuit by the government, accusing UnitedHealth of obtaining over $1 billion in Medicare payouts, remains pending, the report said.
Defendants in the dismissed case included UHC of California, United HealthCare Services, Optum, OptumInsight, UnitedHealthcare and UHIC Holdings.
Twitter: @SusanJMorse
Email the writer: susan.morse@himssmedia.com
