News of the investigation was first reported by Wall Street Journal on Friday: "The new civil fraud investigation is examining the company's practices for recording diagnoses that trigger extra payments to its Medicare Advantage plans, including at physician groups the insurance giant owns."
Articles from last year showed that Medicare paid UnitedHealth billions of dollars for questionable diagnoses. "Attorneys with the Justice Department as recently as Jan. 31 interviewed medical providers named in the articles," WSJ also reported.
AFN reached out to UnitedHealth Group for comment and was told the Wall Street Journal continues to report "misinformation" on the Medicare Advantage (MA) program.
"The government regularly reviews all MA plans to ensure compliance and we consistently perform at the industry's highest levels on those reviews," said UnitedHealth Group. "We are not aware of the 'launch' of any 'new' activity as reported by the Journal. We are aware, however, that the Journal has engaged in a year-long campaign to defend a legacy system that rewards volume over keeping patients healthy and addressing their underlying conditions."
UnitedHealth Group went on to say that "any suggestion that our practices are fraudulent is outrageous and false." Wall Street Journal told AFN that it stands by its reporting.
Meanwhile, Twila Brase, RN and president/co-founder of Citizens' Council for Health Freedom, told AFN that if the Department of Justice isn't actually looking into this matter, it should be.
"The DOJ should look at every Medicare Advantage plan, and look for fraud, look for overcharges, look for upcoding, and look for anyway possible to decrease the cost to American taxpayers," said Brase.
The Associated Press reported on Friday that shares in UnitedHealth Group tumbled following the report of a possible investigation into the company's Medicare billing practices. UNH stock dropped more than 10% during the day on Friday, closing down 7.2%.
