August 01, 2017

Taking Advantage: The DOJ Intervenes in its First Two FCA Whistleblower Actions Against a Medicare Advantage Plan

Samuel M. Shapiro, Arnall Golden Gregory LLP, Washington, DC

In May 2017, the Department of Justice (DOJ) intervened in two whistleblower suits brought against UnitedHealth Group, Inc. (UnitedHealth), alleging that UnitedHealth violated the False Claims Act (FCA) by causing the Centers for Medicare & Medicaid Services (CMS) to pay artificially-inflated amounts in connection with the Medicare Advantage Program.1 These two cases, United States ex rel. Swoben v. Secure Horizons and United States ex rel. Poehling v. UnitedHealth Group, Inc., et al., represent the DOJ’s first interventions in whistleblower FCA cases involving Medicare Advantage.2

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