A US Senate committee's investigation found that UnitedHealth (UNH.US) employed "aggressive strategies" to collect diagnostic information for its Medicare Advantage members that would increase payments.
The new report found that UnitedHealth "turned risk adjustment into a business, which was not its original intent."
The report is based on a review of 50,000 pages of records that UnitedHealth submitted to the US Senate Judiciary Committee last year.
Senator Chuck Grassley, an Iowa Republican and Chairman of the Senate Judiciary Committee, requested these documents in a letter in February, which referenced a 2024 investigation.
That investigation found that UnitedHealth systematically added diagnostic information to patient medical records, thereby securing billions of dollars in additional federal payments.
Some of these diagnoses were allegedly questionable or inaccurate, and many patients did not appear to receive treatment for these newly added conditions.
UnitedHealth faces multiple investigations into its business practices, including civil and criminal probes disclosed by the Department of Justice in July.
A UnitedHealth spokesperson told media that the company disagrees with the report's characterization, adding that UnitedHealth complies with Medicare requirements and performs well in diagnostic audits.
The spokesperson stated, "We remain committed to providing lower-cost, more accessible, higher-quality care to those we serve, including people enrolled in Medicare Advantage."
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