UnitedHealth Fraud Lawsuit Claims Fast-Food Urination Scheme

Employee Benefits News examines legal developments that impact the employee benefits and executive compensation employers provide, including federal and state legislation, rules from federal...

By Jacklyn Wille

United Healthcare Services Inc. sued a Dallas-based drug testing company for more than $100 million in allegedly fraudulent billing, accusing the company of paying people $50 to urinate in a Whataburger restaurant bathroom and then billing the insurer for urinalysis testing ( United Healthcare Servs., Inc. v. Next Health LLC , N.D. Tex., No. 3:17-cv-00243-M, complaint filed 1/26/17 ).

The 11-count complaint, filed Jan. 26 in a federal court in Texas, claims that Next Health LLC and various subsidiaries engaged in bribes, kickbacks and other fraudulent billing practices that cost United more than $100 million. The Whataburger bathroom scheme alone cost United more than $11 million in a single year, the lawsuit claims.

The lawsuit builds off a Department of Justice investigation into Forest Park Medical Center, which in 2016 led to an indictment of 21 physicians and health-care executives connected to the now-bankrupt luxury hospital. United’s lawsuit claims that Next Health’s scheme of paying bribes and kickbacks to doctors and sales consultants in exchange for drug test orders is similar to the scheme allegedly perpetrated at Forest Park.

In general, the lawsuit accuses Next Health of paying 20 percent kickbacks to physicians and medical providers that forwarded urine and saliva samples to Next Health for processing and analysis. Next Health also oversaw a web of subsidiaries and affiliated entities designed to obscure the nature of its billing practices, the lawsuit claims.

In addition to the Whataburger scheme, the lawsuit describes other improper methods Next Health allegedly employed in order to obtain saliva and urine for testing. In some instances, Next Health agents allegedly promised people $50 gift cards for participating in a fictitious “wellness study” designed to collect their urine, a scheme reported by CBS News in 2016.

Next Health also billed for testing services that weren’t requested by doctors and forced doctors into blanket authorizations that allowed testing for all future patients without medical necessity, the lawsuit claims.

The lawsuit names as defendants two men indicted in connection with Forest Park, Semyon Narosov and Andrew Hillman. Narosov and Hillman held ownership or management positions with Next Health, the lawsuit claims, in addition to their connections with Forest Park.

Next Health didn’t immediately respond to Bloomberg BNA’s request for comment.

The lawsuit was filed in the U.S. District Court for the Northern District of Texas by Weinberg Wheeler Hudgins Gunn & Dial LLC.

To contact the reporter on this story: Jacklyn Wille in Washington at jwille@bna.com

To contact the editor responsible for this story: Jo-el J. Meyer at jmeyer@bna.com

Copyright © 2017 The Bureau of National Affairs, Inc. All Rights Reserved.

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