According to the whistleblower lawsuit, UnitedHealth Group obtained money from Medicare to which it wasn’t entitled, totaling around $1 billion in massive Medicare fraud. The Justice Department alleges in its lawsuit that UnitedHealth would give false information about the health status of patients enrolled in its Medicare Advantage plans, and use that inaccurate information to receive inflated risk adjustment payments.

This ongoing practice allegedly led to over $1.14 billion in funds taken from Medicare between 2011 and 2014. In response, the Justice Department is seeking treble damages under the False Claims Act—meaning triple the amount of the fraud itself. On top of this, the Justice Department further seeks punitive damages, or penalty charges.

Payout for the whistleblower who called attention to this issue will likely be substantial, somewhere in the millions.

The whistleblower lawsuit was filed in Los Angeles federal court after another, similar lawsuit earlier that month. The first lawsuit was brought against UnitedHealth Group by a former executive of the company, Benjamin Poehling. Poehling’s case was filed in 2011. Both of these claims were brought to the attention of the government via whistleblower lawsuits, which are the government’s best weapon to combat massive Medicare fraud.

UnitedHealth has stated previously that it would fight the claims made in the original whistleblower lawsuit, but it has yet to make comment about this Justice Department’s massive Medicare fraud lawsuit.

More than 50 million elderly or disabled Americans are served by Medicare, a health insurance program provided by a government. UnitedHealth Group is one of several private insurers that run Medicare Advantage plans, which serve about one third of these 50 million.

Filing a Whistleblower Lawsuit

Whistleblowers are often employees or former employees who see potential fraud or illegal activities in their workplace against the government and report the fraud in a whistleblower lawsuit.

Although whistleblowers may be current employees of the company committing fraud, they are often former employees reporting fraud that they witnessed while at their job. Indeed, many potential whistleblowers may be worried that they will get in trouble for reporting fraud, and they choose to keep silent or wait until they have left their position to accuse their former employers of fraud. However, whistleblowers are often given a substantial whistleblower reward for their reports, which can often be between 15 and 30 percent of the settlement or judgment amount.

Filing a lawsuit under the False Claims Act, a set of federal rules prohibiting kickbacks and fraudulent Medicare claims, can result in severe damages and penalties.

If you believe you have been witness to some kind of fraud against the government, such as Medicare billing fraud, you may be eligible to file a whistleblower lawsuit on behalf of the government.