DOJ launches probe into UnitedHealth’s Medicare billing practices: report

The Ministry of Justice would have launched an investigation into civil fraud on the invoicing practices of Medicare of United Headhealth as a company – and the insurance industry as a whole – is faced with a meticulous examination.

The DoJ examines how Unitedhealth Group records diagnoses that have triggered additional payments to its Medicare Advantage plans, sources familiar with the case at the Wall Street Journal said.

At the end of last year, an analysis of the newspaper showed that billions of Medicare files have revealed a significant increase in lucrative diagnoses for patients seen by doctors of Unitedhealth after having registered at the Medicare Advantage ‘business.

Unitedhealth said in a statement that the government regularly examines all media plans to ensure that they are in accordance and that the company performs “at the highest levels of the industry on these exams”.

“Any suggestion that our practices are fraudulent are scandalous and false,” said Unitedhealth.

Thanks to Medicare, the federal government’s insurance program, people aged 65 and over can register for Medicare Part A and Part B, which offer hospital and medical insurance. They can also opt for Medicare Part C, also known as Medicare Ad (Michael Nagle / Bloomberg via Getty Images / Getty Images)

Thanks to health insurance, the federal Government insurance program, People aged 65 and over can register for Medicare Part A and Part B, who offer hospital and medical insurance. They can also opt for Medicare Part C, also known as the Advantage Medicare Plan. This is a plan approved by the health insurance of a private company which offers an alternative to home health insurance and includes part A, part B and generally part D, which contributes to covering the cost of prescription drugs.

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Lawyers from the Ministry of Justice interviewed the medical providers cited in the previous reports of the journal exposing the way Medicare would have paid billions of dollars to Unitedhealth for doubtful diagnoses. These interviews took place as recently as on January 31, according to the newspaper.

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But the survey is added to a long list of misfortunes for the company, which faced a public control attack on its refusals of care even before the CEO of Unitedhealth, Brian Thomposon, was shot down to the ‘Outdoor of a New York hotel in December in what the police called a “pre-suited and targeted attack.”

A general view outside the headquarters of United Healthcare on December 4, 2024 in Minnetonka, Minnesota. (Stephen Maturen / Getty Images / Getty Images)

Last fall, a Senate subcommittee Accused Unitedhealthcare Group of refusing allegations to an increasing number of patients while he was trying to take advantage of artificial intelligence to automate the process. The report affirmed that the rate of refusal of prior authorization of Unitedhealthcare for post-supreme care rose from 10.9% in 2020 to 22.7% in 2022. United refuted these claims, claiming that the report “badly On the Medicare Advantage program and our clinical practices “.

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He came at the same time as the DOJ and the general prosecutors of Maryland, Illinois, New Jersey and New York brought civil legal action to block the proposed acquisition of 3.3 billion Dollars of Palliative Health and Palliative Care Services. The agreement would threaten care for vulnerable patients and harm nurses at home and palliative care.

The Ministry of Justice refused to comment.

Fox Business contacted the office of the Inspector General of the Ministry of Health and Social Services, which is also involved in the survey, for comments.