In an early mixed valentine for both the
government and a defendant Medicare Advantage Plan insurer, a district court in
California on February 12 denied a motion to dismiss reverse FCA claims alleging
the failure to correct known invalid diagnosis codes submitted for risk adjustment
payments to Medicare. The court did dismiss, however, the government’s claims
that the insurer’s false statements as to the validity of the diagnosis codes also
violated the FCA. Poehling v. Unitedhealth
Group, Inc., No. 2:16-cv-08697 (C.D. Cal. Feb. 12, 2018).