Tag:UnitedHealthcare
Profits Over Patients: The DOJ’s Fraud Investigation into UnitedHealth’s Medicare Practices
The Department of Justice (DOJ) has launched a civil fraud investigation into UnitedHealth’s Medicare billing practices, scrutinizing allegations that the company improperly inflated patient diagnoses to secure higher federal payments. While the investigation was publicly announced via the Wall Street Journal recently, it has been underway since 2024. This development follows the December 2024 death of UnitedHealth CEO Brian Thompson, which sparked renewed public discourse on the ethics of insurance companies. Many individuals came forward with stories of denied coverage for life-saving treatments, raising broader concerns about the practices of private insurers managing Medicare benefits.
DOJ Joins Whistleblower Suit Against UnitedHealth Group
The United States Department of Justice (“DOJ”) recently intervened in a qui tam action against UnitedHealth Group (“United”) and its subsidiary, UnitedHealthcare Medicare & Retirement, the nation’s largest provider of Medicare Advantage (“MA”) Plans. The suit alleges that United engaged in an “up-coding” scheme to receive higher payments than they should have under MA’s risk adjustment program. Assuming these allegations of United’s false claims are true, then United billed and received hundreds of millions of dollars in improper payments from Medicare.