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.”