The Department of Justice has reportedly launched a civilian fraud probe into UnitedHealth Group's Medicare billing practices arsenic the institution – and the security manufacture arsenic a full – look accrued scrutiny.
The DOJ is looking into however UnitedHealth Group records diagnoses that acceptable disconnected other payments to its Medicare Advantage plans, sources acquainted with the substance told the Wall Street Journal.
Late past year, an investigation by the Journal showed that billions of Medicare records revealed important increases successful lucrative diagnoses for patients seen by UnitedHealth-employed doctors aft enrolling successful the company’s Medicare Advantage plans.
UnitedHealth said successful a connection that the authorities regularly reviews each Medicare Advantage plans to guarantee that they are compliant and that the institution performs "at the industry’s highest levels connected those reviews."
"Any proposition that our practices are fraudulent is outrageous and false," UnitedHealth said.
Through Medicare, the national government's security program, radical who are property 65 and older tin motion up for Medicare Part A and Part B, which supply infirmary and aesculapian insurance. They tin besides opt for Medicare Part C, besides known arsenic a Medicare Advantage plan. It is simply a Medicare-approved program from a backstage institution that offers an alternate to Original Medicare and includes Part A, Part B and usually Part D, which helps screen the outgo of medicine drugs.
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Justice Department attorneys person been interviewing aesculapian providers cited successful the Journal's anterior reports exposing however Medicare allegedly paid billions of dollars to UnitedHealth for questionable diagnoses. Those interviews took spot arsenic precocious arsenic January 31, according to the Journal.
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But the probe adds to a agelong database of woes for the company, which has faced an onslaught of nationalist scrutiny implicit its denials of attraction adjacent earlier UnitedHealth CEO Brian Thomposon was gunned down extracurricular a New York City edifice successful December successful what constabulary person called a "pre-meditated, targeted attack."
Last fall, a Senate subcommittee accused UnitedHealthcare Group of denying claims to a increasing fig of patients arsenic it tried to leverage artificial quality to automate the process. The study claimed that UnitedHealthcare’s anterior authorization denial complaint for post-acute attraction jumped from 10.9% successful 2020 to 22.7% successful 2022. United refuted these claims, saying the study "mischaracterizes the Medicare Advantage programme and our objective practices."
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It came astir the aforesaid clip that the DOJ and attorneys wide of Maryland, Illinois, New Jersey and New York filed a civilian antitrust suit to artifact UnitedHealth Group's projected $3.3 cardinal acquisition of rival location wellness and hospice services supplier Amedisys Inc. implicit concerns that the woody would endanger attraction for susceptible patients and harm location wellness and hospice nurses.
The Department of Justice declined to comment.
FOX Business reached retired to the Department of Health and Human Services’ Office of Inspector General, which is besides progressive successful the investigation, for comment.
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