We’ve written before about two high profile cases that the United States has been pursuing against UnitedHealth Group, based on allegations that the company was categorizing its Medicare Advantage (i.e. Medicare Part C) patients as sicker than they really were in order to increase reimbursement from the United States.
In October, a federal judge dismissed one of those two related cases, raising questions about whether the Government’s theory of liability might be dead in the water. But that no longer appears to be the case. Last week, the federal judge in the remaining case – U.S. ex rel. Poehling v. UnitedHealth Group – denied the Defendant’s motion to dismiss, ruling that the Justice Department sufficiently alleged that UnitedHealth submitted invalid diagnostic data related to the health of its Medicare Advantage patients. While the judge dismissed a few of the Government’s theories of liability, the case as a whole can now proceed to discovery, which is a big win for both the United States and the whistleblower who initially brought the case.
To learn more about our Whistleblower & Qui Tam practice click here. Our firm is located in Nashville, Tennessee but we represent whistleblowers all around the country.
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