The DOJ has started a radical fraud investigation into UnitedHealth because he would have withdrawn the government from millions through fraudulent invoicing practices.
The new civilian fraud probe would have an evaluation of the company's practices for the inclusion of diagnoses that cause additional payments to the Medicare Advantage plans.
A Wall Street Journal research showed that Medicare UnitedHealth has paid for millions of dollars for doubtful diagnoses in recent years.
In Medicare Advantage, private insurers receive fixed payments from the federal government to manage the medicine benefits of registered persons.
These payments increase when patients are diagnosed with rare or difficult to treat disorders, which encourages insurers to establish more profitable health problems.
The UnitedHealth Group shares tumbled on Friday with the news of the investigation into civilian fraud. Shares from other prominent Medicare benefit insurers such as Humana had also fallen.
The news of the research and the subsequent financial hit comes less than three months after Brian Thompson, CEO of Unitedhealthcare, was shot in a street in Manhattan.
The Ministry of Justice has started a broad fraud investigation into insurance giant UnitedHealth, and accuses the company of cheating the government from millions by covering questionable diagnoses
For his part, UnitedHealth retains its innocence: “Every suggestion that our practices are fraudulent is outrageous and false.”
This is not the only legal jumble with the government in which UnitedHealth has recently been located.
Last year, the DOJ also sued that the conglomerate for health care for $ 3.3 billion home assistance provider Amedisys Inc. acquires.
Moreover, the DOJ has a constant lawsuit against UnitedHealth with regard to Medicare Advantage, which will be tried in October.
UnitedHealth, a $ 400 billion company that owns the largest American health insurer and a vast network of other health industry assets, also includes more than 7.8 million people as the largest provider of Medicare Advantage plans in the country
The continuous reporting of the Wall Street Journal has revealed what the Doj now sees as a joint effort from insurers to cheat on the government.
However, the DOJ has not unveiled the amount of money that it thinks was wrongly distributed.
A WSJ analysis of Medicare records revealed a significant increase in profitable diagnoses for patients who were seen by doctors in the service of UnitedHealth after they joined the Medicare Advantage Plans of the company.
UnitedHealth manages the largest health insurer in the country, Unitedhealthcare, which includes more than 49 million Americans
Doctors claimed that UnitedHealth, based in Minneapolis, trained them to document diagnoses that would generate income, including some those irrelevant or unclear seemed.
According to the doctors who spoke with the magazine, the company also used software to propose conditions and offer bonuses for considering these suggestions.
Moreover, the magazine reported last summer that UnitedHealth Diagnoses added for disorders that were not treated by a doctor, which resulted in an extra $ 8.7 billion in federal payments in 2021.
These diagnoses were linked to sources such as home visits by nurses from the Housecalls unit of UnitedHealth, which generated an average of $ 2,735 of extra federal payments from 2019 to 2021.
UNH shares fell 8.7 percent on Friday, causing their weekly decrease to more than 12 percent. The stock is now on schedule to experience its worst daily and weekly performance since 2020.
The company said: 'The Wall Street Journal remains wrong information about the Medicare Advantage (MA) program Report.
“The government regularly assesses all MA plans to guarantee compliance and we consistently perform at the highest levels of the industry on those assessments.”
In a further shot at the report of the journal, UNH said: 'We are not aware of the' launch 'of a' new 'activity as reported by the magazine.
The company has lost part of his foot since the shocking shooting from the former CEO Brian Thompson on December 4. The current share price is around $ 458 per share. On the day of the murder of Mr. Thompson it was $ 610
“However, we are aware that the magazine has entered into a one-year campaign to defend a legacy system that rewards volume about keeping patients healthy and tackling their underlying disorders.”
The company has lost part of his foot since the shocking shooting from the former CEO Brian Thompson on December 4.
The company has since lost around $ 63 billion in value and the price of shares has fallen by around $ 100. The current share price is around $ 458 per share. On the day of the murder of Mr. Thompson it was $ 610.
UnitedHealth operates the largest health insurer in the country, Unitedhealthcare, which includes more than 49 million Americans.
It also supervises a pharmacy -benefit manager that manages prescription drugs and has other lucrative assets.
James Harlow, senior vice president at Novare Capital Management, said: 'Selling investors because it creates an unknown that it is difficult to quantify – it is impossible to really know how the research will unfold on this point and what the ultimate impact will be On UNH's profitability. '
