UnitedHealth used HRAs, chart review to boost Medicare Advantage profits

For the nation’s largest well being insurer, the proof of abuse was beautiful and unmistakable: UnitedHealth Group reaped billions from the federal Medicare program by diagnosing sufferers with severe power sicknesses, after which delivering no follow-up care.

The findings within the federal report reveal that UnitedHealth repeatedly despatched clinicians into sufferers’ properties and pored over their medical charts so as to add diagnoses for sicknesses comparable to vascular illness, coronary heart failure, and diabetes. The aim was to gather more money in Medicare Benefit — to not enhance their well being. The consequence? $3.7 billion in doubtful funds final yr alone.

The revelations contradict a core declare of UnitedHealth’s public messaging about its principal Medicare enterprise technique — that it’s centered on figuring out circumstances early and conserving sufferers wholesome — and will usher in additional investigations and new restrictions that clamp down on its major methods of getting cash.