UnitedHealth being sued for Medicare Advantage fraud

The U.S. Department of Justice has joined a whistleblower lawsuit against UnitedHealth, alleging the insurer improperly received billions of dollars through Medicare Advantage.

The accusations were made in 2011, according to the New York Times, through a False Claims Act lawsuit by former UnitedHealth executive Benjamin Poehling. Though his complaint mentioned 15 companies and several claims of fraud, the DOJ is only intervening in cases involving UnitedHealth and its subsidiary, WellMed Medical Management, and only on the charges of erroneous coding and overbilling.

UnitedHealth said the lawsuit is based on an incorrect interpretation of Medicare rules.

“We reject these more than five-year-old claims and will contest them vigorously,” said company spokesman Matthew Burns.

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John Gregory, Senior Writer

John joined TriMed in 2016, focusing on healthcare policy and regulation. After graduating from Columbia College Chicago, he worked at FM News Chicago and Rivet News Radio, and worked on the state government and politics beat for the Illinois Radio Network. Outside of work, you may find him adding to his never-ending graphic novel collection.

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