UnitedHealth fudged Medicare claims, overbilled by $1 billion, feds say
Source: Center for Public Integrity.
The Justice Department has accused insurance giant UnitedHealth Group of overcharging the federal government by more than $1 billion through its Medicare Advantage plans.
In a 79-page lawsuit filed late Tuesday in Los Angeles, the Justice Department alleged that the insurer made patients appear sicker than they actually were in order to collect higher Medicare payments than the company deserved. The government said it had conservatively estimated that the company knowingly and improperly avoided repaying Medicare for more than a billion dollars over the course of the alleged decade-long scheme
Read more: https://www.publicintegrity.org/2017/05/17/20868/unitedhealth-fudged-medicare-claims-overbilled-1-billion-feds-say
Judi Lynn
(160,218 posts)SharonAnn
(13,767 posts)I told my boss they were unethical and I didn't want to do project work for them.
He reassigned me to another company.
DK504
(3,847 posts)Thank you!
nitpicker
(7,153 posts)Delphinus
(11,808 posts)that thread link.
Cha
(295,925 posts)Advantage program works"
Is it United or is the trump fed gov?
I don't know but if it's the same United Health that is out here in Hawaii.. they have great reputation.
metalbot
(1,058 posts)Doctors set the ICD-10 codes that represent their treatments, and United Health bills the government for those codes.
If United were altering patient records to change the ICD-10 codes, it's blatant fraud, but it's also something that would make it ridiculously easy to audit and catch. Medicare fraud happens most often at the Doctor level, not the insurance level.
Edit to add: it may be that they had ICD-10 codes that were being used to make the risk scores, but when those codes were reused that they kept the risk scores?
I wonder who's campaigns some of this bilking ended up greasing?
Honeycombe8
(37,648 posts)It doesn't get much worse than Blue Cross. I thought United was better, but apparently not.
They're all corrupt.
DK504
(3,847 posts)I thought when Skeltor of Florida, when owner, got popped a few years ago.
DFW
(54,055 posts)I do know that my outfit had them and dropped them many years ago, and it wasn't because they were good or helpful.
More like John Grisham's fictitious "Great Benefit."
wcollar
(175 posts)Keeping his word about charging criminals with the maximum penalty allowable under the law.
Somehow though, I don't think this is what he had in mind.
lostnfound
(16,138 posts)Not.