Suit Says, Scheme Tied to UnitedHealth Overbilled Medicare for Years

Suit Says, Scheme Tied to UnitedHealth Overbilled Medicare for Years

A leading health insurer in the nation, UnitedHealth Group, has been accused of indulging in a scheme that permits its insurers and subsidiaries to charge Medicare overly in an improper manner. This statement was given by a lawsuit on Thursday at the request of the Justice Department.

The accusations are being held against Medicare Advantage, which is a program that enables people at the age of 65 or above to avail services provided by private health organizations. This was initiated in the year 2003 and the insurers think that managed care would cover up the cost of Medicare, which has been draining the federal budget much faster as compared to the inflation rate.

The lawsuit states that UnitedHealth must have made efforts to decrease the costs; however, they have added extra costs over many years, which have now accumulated to billions of dollars. This lawsuit was unsealed in Los Angeles Federal District Court.

Matthew A. Burns, a UnitedHealth spokesperson defended the assertion and said that the lawsuit has been formed on the rules of Medicare that were interpreted in a faulty manner. He also said that they would fight these claims and that they are confident that they have complied to all the rules and provided all its members with quality health services.

The federal government and insurers from a long time have been struggling to understand how Medicare is being billed by the private plans for the past many years. Several UnitedHealth companies had sued the Health and Human Services Department the previous year and challenged the then-proposed rules regarding the overpayment handling by Medicare.

Some of these whistle-blowers at that time filed lawsuits against the insurers accusing them of overcharging the programs that also include audits of government causing trouble for the past many years.

The notice by the Justice Department court revealed that a lawyer, Chad Readler had filed the case that involves UnitedHealth. Chad Readler has been appointed at the civil division under the administration of the new US president, Donald Trump. This has been interfering in the claims provided by the whistle-blowers that are emphasizing on the inflating of bills and coding that is becoming erroneous, but is making no point as far as other claims are concerned. If the government wants to file a complaint on its own, then it has ninety days to file its own complaint.

These accusations that are being made publicly began in the year 2011. The reason for this was Benjamin Poehling, a former executive of UnitedHealth, who had a complaint filed pertaining to the False Claims Act. The False Claims Act is a law that permits citizens to privately take legal actions if they feel that a program by the government is being defrauded.

Share this post

Post Comment