The U.S. Justice Department dumped its lawsuit accusing UnitedHealth Group and affiliated health plans of exaggerating how sick its patients were to score millions of dollars in inflated Medicare Advantage payments.
The federal government informed U.S. District Judge John Walter late Thursday that it would no longer pursue the False Claims Act case against the national insurer. Walter had dismissed the lawsuit on Oct. 5, ruling that the Justice Department's allegations were too vague.
"We are pleased with the government's decision to dismiss these meritless claims," UnitedHealth said in a statement.
The Justice Department claimed UnitedHealth, the nation's largest Medicare Advantage insurer, had inflated plan members' risk scores since at least 2005. The CMS adjusts its per-beneficiary fee to insurers based on those risk scores. There have been several whistle-blower lawsuits in recent years alleging health plans inflate members' risk scores to secure higher payments.
But the government failed to allege that specific UnitedHealth employees knew about the upcoding, or that the CMS wouldn't have paid UnitedHealth if those alleged inflations hadn't happened.
A whistle-blower first sued UnitedHealth over the inflated Medicare Advantage payments in 2009. The Justice Department didn't intervene in the suit until May 2017. It joined another similar suit against the insurer in February 2017.
