The federal government’s False Claims Act (FCA) case against United Health Group (UHG) continues after major developments. In the case of U.S. ex rel. Benjamin Poehling v. UnitedHealth Group, Inc., The U.S. District Court in the Central District of California dismissed half of the claims brought through the initial qui tam suit and the government’s revised complaint. A short time later, the Department of Justice (DOJ) decided to not continue with a part of the suit and to focus on the remaining claims.
The District Court’s Decision
In February 2018, the district court analyzed the government’s amended complaint based on the FCA’s materiality requirement. Based on the Supreme Court’s decision in Universal Health Servs. Inc. v. United States ex rel. Escobar, the government must plead that their allegations are material to the government’s payment decision. They must demonstrate that, if the facts are true, the unlawful conduct influenced how much the government paid the other party.