News Briefs: DOJ Gets Extension to Respond to Recommendation in UnitedHealth Risk Adjustment Case
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Mar 20, 2025
After the special master who reviewed a False Claims Act lawsuit against UnitedHealth Group sided with the defendant, a federal judge gave the U.S. Dept. of Justice (DOJ) an extension on filing an objection. On March 3, a retired judge serving in the court-appointed role of special master concluded that the federal government failed to provide evidence to support its essential claims in U.S. ex rel. Benjamin Poehling v. UnitedHealth Group, Inc. (16-08697). The case, filed by former UnitedHealth employee Poehling in 2011, accuses the insurer of violating the False Claims Act by conducting chart reviews to find additional diagnoses for risk adjustment purposes. The DOJ intervened in 2017 and amended its complaint in 2018. The parties were given 14 days to file motions responding to the special master’s recommendation. The DOJ, which is expected to dispute the recommendation, has until April 2 to file its motion for review. UnitedHealth must file an opposition to the motion by May 2, to which the DOJ must reply by May 19. If the case proceeds to trial, the proposed date is July 7, 2026, according to the parties’ joint order.
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