US EditionUnitedHealth used aggressive Medicare tactics, Senate committee report says
UnitedHealth used AI and targeted workforce to increase Medicare Advantage risk scores, boosting federal payments in a program covering over 8 million enrollees, Senate report says.
- On Monday, the Senate Judiciary Committee released a report finding UnitedHealth Group Inc. used aggressive strategies to collect diagnoses that increased Medicare Advantage payments and turned risk adjustment into a profit-driving use.
- Sen. Chuck Grassley’s office reviewed roughly 50,000 pages of internal documents UnitedHealth provided last year, based on documents turned over during the probe that began at least a year ago.
- UnitedHealth’s materials show its workforce and AI deployed in‑home nurses, clinical coders, and external providers to identify additional diagnoses raising risk scores without confirmatory tests.
- UnitedHealth Group Inc. disclosed a DOJ probe in July and faces ongoing investigations while its shares fell as much as 2.9%, and CEOs, including Stephen Hemsley, will face House committees on Jan. 22.
- With nearly half a trillion dollars paid to private insurers in 2024, UnitedHealth, a $400 billion healthcare conglomerate, and its UnitedHealthcare unit, covering over 8 million Medicare Advantage enrollees, have turned risk adjustment into a major profit strategy, the Senate Judiciary Committee report said.
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UnitedHealth Group Incorporated $UNH Shares Sold by Harbor Investment Advisory LLC
Harbor Investment Advisory LLC reduced its stake in shares of UnitedHealth Group Incorporated (NYSE:UNH – Free Report) by 25.5% in the 3rd quarter, according to its most recent disclosure with the Securities and Exchange Commission. The firm owned 20,358 shares of the healthcare conglomerate’s stock after selling 6,986 shares during the period. Harbor Investment Advisory LLC’s holdings in UnitedHealth Group were worth $7,030,000 at the end of th…
UnitedHealth used aggressive Medicare tactics, Senate committee report says
Health insurer UnitedHealth Group used aggressive risk-adjustment coding tactics to increase U.S. government reimbursement for patients enrolled in its Medicare Advantage healthcare plans, a U.S. Senate committee report said on Monday.
Grassley releases report accusing UnitedHealth of ‘gaming’ Medicare Advantage to boost diagnoses
Sen. Chuck Grassley (R-Iowa) on Monday released the findings of his investigation into UnitedHealth Group’s (UHG) Medicare Advantage billing practices, alleging the health insurer used “aggressive strategies” to maximize risk adjustment scores and worked against federal efforts to tamp down overspending. Last year, Grassley launched an investigation into UHG’s billing practices after The Wall Street…
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