UnitedHealth Group Inc (NYSE:UNH), the country’s largest health insurer is alleged to have inflated payments. As a result, the U.S. Justice Department has taken legal action against it, which has occasioned the filing of a lawsuit at the federal court in Los Angeles. The DOJ claims that the insurer did not disclose the correct information pertaining to the health status of patients who had been registered in the Medicare Advantage Plan.
This is not the first time that the insurer is finding itself in trouble. Earlier in the year, the Justice Department mediated in another separate whistleblower lawsuits against it.
UnitedHealth allegedly did nothing to correct inaccurate information
The 39-page complaint outlines that the insurer had been presenting many diagnosis codes to the Medicare program. However, a majority of them had not been in line with the patient’s records. Surprisingly, even after realizing the error, it did not facilitate any form of correction.
The lawsuit is just the beginning of many other insurers who could be doing the same. Sandra Brown, the acting U.S. Attorney in Los Angeles mentioned, “This action sends a warning that our office will continue to scrutinize and hold accountable Medicare Advantage insurers to safeguard the integrity of the Medicare program.”
UnitedHealth refutes claims
UnitedHealth does not agree with the claims by the Justice Department despite the filing of the lawsuit. The company’s spokesperson, Matthew Burns has rejected them citing that they followed the required rules and that they also invoked transparency. As the case now moves to court, it remains to be seen what measures shall be taken against the insurer.
In the meantime, the House Subcommittee on Oversight and Investigation has acknowledged fraud activities within Medicaid Personal Care Services, which is a sister program to Medicare. There have been extensive protests of prescription pill theft as well as elder abuse by in-home attendants.
Nonetheless, with more than 200 abuse cases having been filed, Christi Grimm, the OIG Chief of Staff recommends the need for establishing modern ways of taking care of the abuses. She says that having care attendants on board would be helpful. Meanwhile, UnitedHealth’s stock closed at $174.14 a fall of $ 0.45 or 0.26%.
