Justice Department joins billion dollar lawsuit against UnitedHealth Group for fraud in Medicare Advantage

The Department of Justice joined whistleblower’s lawsuit against  UnitedHealth Group accused of fraud in its popular Medicare Advantage health plans. The suit, first brought by whistleblower James Swoben in 2009, on Friday in federal court in Los Angeles accused the insurer of “gaming” the Medicare Advantage payment system by “making patients look sicker than they are.”  Damages may exceed $1 billion according to his counsel. Medicare Advantage is an alternative to traditional Medicare. The privately run health plans have enrolled more than 18 million elderly and people with disabilities — about a third of those eligible for Medicare — at a cost to taxpayers of more than $150 billion a year.


On Monday, the government said it wants to consolidate the Swoben case with another whistleblower action filed in 2011 by former UnitedHealth executive Benjamin Poehling and unsealed in March by a federal judge. Poehling also has alleged that the insurer generated hundreds of millions of dollars or more in overpayments.

Jeffrey Newman represents whistleblowers.