UnitedHealth Group said Thursday that its Medicare business is under investigation by the Justice Department.
The health insurer said it adheres to the department’s formal criminal and civil investigations of its participation in the Medicare program and initially linked with the Department of Justice after seeing media reports centering on an investigation into “some aspects” of UnitedHealth Medicare practice.
The company added that it launched itself Third-party comments “Risk Assessment Coding, policies, practices and related processes and performance indicators for managed nursing practices and pharmacy services.”
in May, The Wall Street Journal reported The Justice Department is conducting a criminal investigation into the company’s health insurance billing practice. The journal previously reported in February that the company is in Investigation by the Ministry of Civil Justice Used in health insurance practice.
One week after May report, Reported UnitedHealth allegedly deployed its in-house healthcare team to about 2,000 nursing homes and provided cash incentives to limit the transfer of hospitals to cut costs under its Medicare Advantage program. Internal records viewed in newspapers and whistleblower accounts show that treatment for some residents who are desperate for hospital care has been postponed or even denied, resulting in long-term losses.
Bonus are reportedly related to hospitalization rates, with one of the main measures marked as “ten million inclusions”, while high interest rates mean no financial returns. Nursing home staff are allegedly encouraged to change the patient’s code status to “not recover” and use health records to help potential participants.
In the statement provided to Quartz, UnitedHealth says As part of a multi-year investigation, the Justice Department investigated these claims, interviewed witnesses, reviewed thousands of documents, and eventually “refuse to pursue the matter” after discovering “serious de facto inaccuracy.”
UnitedHealth has previously suspended its financial guidance for 2025, attributed to the unexpectedly high medical expenses of the new Medicare Advantage Adroles.
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– Shannon Carroll contributed to this article.
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