United Healthcare Services will proceed with its lawsuit against Next Health for allegedly engaging in a $100 million fraud scheme over five years, Bloomberg Law reported.
Here are the key facts in the case:
1. In the lawsuit filed last year, United alleged Next Health paid its subsidiaries and individuals $50 to urinate in a restaurant bathroom instead of in a lab, then billed the insurer for urinalysis testing.
2. Judge Karen Gren Scholer of the U.S. District Court for the Northern District of Texas ruled in favor of United's claims based on information provided by the laboratories and their billing practices, which is an early win for United.
3. Judge Scholer rejected Next Health's attempt to frame United's misrepresentation claims as a denial of payment on behalf of its members, saying United’s claims only apply to whether Next Health gave the insurer truthful and complete information.
4.Judge Scholer ordered Next Health to include more information in support of their counter-claims against United.