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The California Public Employees’ Retirement System on Tuesday approved an increase in health care costs for state and local government employees as the economic slowdown caused by the coronavirus pandemic batters tax collections.

Depending on the plan, the increased health maintenance organization premiums for state workers from the previous year will range from 1.62% to 9.37%, or an average of 4.44%. For participating public agencies and schools, the HMO increase ranges from 0.82% to 11.96% depending on the region and plan.

The preferred provider organizat...

UnitedHealth Group ended the first quarter of 2020 with a $3.4 billion profit, according to financial results released April 15.

UnitedHealth said its first-quarter results "reflect minimal impact from the progression of the COVID-19 virus across the U.S." as coverage expansions and funding initiatives largely took place at the back end of the quarter. UnitedHealth committed to accelerating payments to providers and funding other initiatives during the COVID-19 pandemic.

In the first quarter of this year, UnitedHealth saw overall revenue grow 6.8 percent year over ye...

The behavioral health units of UnitedHealthcare and Cigna face four class-action lawsuits claiming the insurers conspired with a third-party company to underpay providers and balance bill patients hundreds of millions of dollars.

The lawsuits, filed by law firm Napoli Shkolnik April 5, accuse United Behavioral Health and Cigna Behavioral Health of using Viant as a middleman company to systematically lower payments to out-of-network outpatient providers for substance abuse and mental health treatment. The lawsuit alleges providers got less than 5 percent of what they...

The nation's largest health insurer, UnitedHealth Group, is following rival Anthem's footsteps with a new payment policy aimed at reducing its emergency department claims costs.

Under the policy, rolled out nationwide March 1, UnitedHealth is reviewing and adjusting facility claims for the most severe and costly ED visits for patients enrolled in the company's commercial and Medicare Advantage plans.

Hospitals that submit facility claims for ED visits with Level 4 or Level 5 evaluation and management codes—codes used for patients with complex, resource-intensive...

The Justice Department has sued UnitedHealth Group, saying that senior executives knew the company was overbilling Medicare by hundreds of millions of dollars a year, and halted a repayment plan in 2014 so the money could be used to meet Wall Street’s revenue expectations.

In a complaint filed Tuesday in United States District Court in Los Angeles, the Justice Department said UnitedHealth routinely combed through millions of patients’ medical charts, searching for data it could use to make patients look sicker than they really were, in what the lawsuit called “stric...

Federal prosecutors slapped a multi-billion dollar Medicare fraud charge against United Health Group (UHG) and a key subsidiary President Barack Obama’s former top insurance official once headed, according to an investigation by The Daily Caller News Foundation.

It was the third time health fraud charges have been filed against United and its two major subsidiaries, Optum and OptumInsight.

United spokesman Matthew Burns denied the allegations, saying in a statement, “We reject these more than 5-year-old claims and will contest them vigorously.”

Andy Slavitt, who led t...

The Justice Department has joined a California whistleblower's lawsuit that accuses insurance giant UnitedHealth Group of fraud in its popular Medicare Advantage health plans.

Justice officials filed legal papers to intervene in the suit, first brought by whistleblower James Swoben in 2009, on Friday in federal court in Los Angeles. On Monday, they sought a court order to combine Swoben's case with that of another whistleblower.

Swoben has accused the insurer of "gaming" the Medicare Advantage payment system by "making patients look sicker than they are," said his at...

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