The Department of Justice has filed charges against UnitedHealth Group for overcharging the federal government more than $1 billion through its Medicare Advantage packages.
The suit — filed in a Los Angeles court — said UnitedHealth made patients appear to be much more infirm than they actually were so they could collect higher Medicare payments.
A report from Salon.com said the federal government’s conservative estimate is that UnitedHealth “knowingly and improperly avoided repaying Medicare” for the more than $1 billion in overcharges during the decade ending in 2016.
U.S Attorney Sandra Brown said, “To ensure that the program remains viable for all beneficiaries, the Justice Department remains tireless in its pursuit of Medicare fraud perpetrated by healthcare providers and insurers. The primary goal of publicly funded health care programs like Medicare is to provide high quality services to those in need — not to line the pockets of participants willing to abuse the system,” she said.
This is the second time UnitedHealth has been under Justice Department scrutiny under the False Claims Act. In 2011 a similar complaint was filed by the firm’s former finance director.
UnitedHealth is the nation’s biggest Medicare Advantage participant and in 2016 it covered 3.6 million policyholders. The price tag for that insurance was $56 billion.
The company denies any wrongdoing and spokesman Matt Burns said it will go to battle over the accusations. “We are confident our company and our employees complied with the government’s Medicare Advantage program rules, and we have been transparent with (Centers for Medicare and Medicaid Services) about our approach under its unclear policies.”
CMS declined to comment.
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