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March 4 (Reuters) - A court-appointed special master has found that U.S. authorities do not have evidence to support their billion-dollar fraud case accusing UnitedHealth Group (UNH.N),of keeping overpayments from the government for patients on its Medicare insurance plans.

The recommendation, by Special Master Suzanne Segal on Monday is not a final ruling, but if it is adopted by U.S. District Judge Fernando Olguin, it would end the U.S. Department of Justice's claims against the health insurer.

https://www.reuters.com/business/healthcare-pharmaceuticals/unitedhealth-wins-favorable-ruling-against-us-fraud-case-2025-03-04/

▪️Medicare Advocacy dot org

New Study – Medicare Advantage Overpayments as High as $140 Billion a Year

OCTOBER 5, 2023

On October 4, 2023, Physicians for a National Health Program (PNHP) released a report titled “Our Payments Their Profits”, showing that insurance companies offering Medicare Advantage (MA) plans are overpaid by up to $140 billion a year by Medicare.

WHY UNITED HEALTHCARE WON THEIR FRAUD CASE

▪️ Feds killed plan to curb Medicare Advantage overbilling after industry opposition

August 28, 2024

2014 decision by CMS, and events related to it, are at the center of a multibillion-dollar Justice Department civil fraud case against UnitedHealth Group pending in federal court in Los Angeles.

. . . A decade ago, federal officials drafted a plan to discourage Medicare Advantage health insurers from overcharging the government by billions of dollars — only to abruptly back off amid an "uproar" from the industry, newly released court filings show. . . .

. . . in May 2014, CMS dropped the idea without any public explanation. Newly released court depositions show that agency officials repeatedly cited [un-named?] concern about pressure from the industry.

https://www.fiercehealthcare.com/payers/feds-killed-plan-curb-medicare-advantage-overbilling-after-industry-opposition

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