UnitedHealth fudged Medicare claims, overbilled by $1 billion, feds say

[factfinder_77]

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]

1. It's time to deal with these criminals seriously. They are NOT honorable people, never have been. nt

[raccoon]

6. +100 nt

[SharonAnn]

11. Not surprised. I asked to be taken off their account years ago.

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]

12. Wow!!! That takes serious ovaries!!!

Thank you!

[nitpicker]

2. See yesterday's thread

https://www.democraticunderground.com/111680332

[Delphinus]

9. Thanks for

that thread link.

[Cha]

3. Company denies wrongdoing, claims Justice Department "fundamentally misunderstands" how Medicare..

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]

7. It should be pretty black and white if it's fraud

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?

[Plucketeer]

14. Gee

I wonder who's campaigns some of this bilking ended up greasing?

[Honeycombe8]

4. I hate to hear this. I thought United Healthcare was the more ethical of the ins. cos.

It doesn't get much worse than Blue Cross. I thought United was better, but apparently not.

They're all corrupt.

[DK504]

13. Isn't this the 2nd time they've been caught doing this?????

I thought when Skeltor of Florida, when owner, got popped a few years ago.

[DFW]

5. I'm not qualified to make a judgement here, but.....

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]

8. Looking forward to AG Sessions

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.

[Delphinus]

10. Haha!

[lostnfound]

15. Insurance companies are sooo much better than single payer..

Not.