The federal authorities has been cracking down on healthcare large UnitedHealth Group over the previous 12 months, and it’s exhibiting no indicators of slowing down.
As an illustration, the Division of Justice started an antitrust probe into the corporate final February, after which in March, HHS launched an investigation into the catastrophic cyberattack suffered by UnitedHealth subsidiary Change Healthcare. The DOJ additionally filed a lawsuit to dam the UnitedHealth Group’s $3.3 billion acquisition of Amedisys in November.
This week, the corporate confronted two new investigations from federal lawmakers — the primary being a senator’s probe into its Medicare Benefit billing practices, and the second being a congressman’s investigation right into a decline in care high quality at UnitedHealth-owned clinics in New York.
The primary new probe got here on Monday, when Senator Chuck Grassley (R-Iowa) initiated an inquiry into UnitedHealth Group’s Medicare Benefit billing. He was prompted by reporting from The Wall Avenue Journal, which urged the corporate might have manipulated billing guidelines for revenue. The report said the DOJ is investigating the corporate for inappropriately inflating its members’ prognosis codes to extend reimbursement funds.
UnitedHealth accused The Wall Avenue Journal of spreading misinformation and denied any fraudulent exercise. The corporate additionally denied that the DOJ launched an investigation into its Medicare Benefit billing practices.
Grassley has requested detailed information from UnitedHealth CEO Andrew Witty, together with compliance paperwork and coaching manuals, to evaluate the corporate’s billing practices.
The following probe got here on Wednesday, when Consultant Pat Ryan (D-New York) launched a group inquiry into care high quality at clinics owned by UnitedHealth subsidiary Optum. The probe, which targets Optum-owned clinics in New York’s Hudson Valley, comes because of constituent complaints about inaccessibility, inaccurate billing, and a discount in care high quality.
“My workplace has been listening to from people throughout the Hudson Valley a few decline in care, particularly at CareMount Medical and Crystal Run Healthcare, following their buy by Optum. I’m launching this group inquiry to listen to from as many people as doable to instantly inform my ongoing oversight,” Ryan mentioned in a press release.
The congressman is searching for extra suggestions from his constituents who obtain care or work at Optum amenities within the Hudson Valley.
UnitedHealth didn’t reply to MedCity Information’ request for touch upon this probe earlier than this text was revealed.
Photograph: MikeyLPT, Getty Photos
