The Wall Street Journal reports the Justice Department has launched a civil fraud probe
of ConsumerAffairsThe U.S. Department of Justice has reportedly launched a civil fraud investigation into insurance giant UnitedHealth concerning its practices involving Medicare Advantage plans.
According to the Wall Street Journal, which cites people familiar with the matter, the probe is examining UnitedHealths practices for recording a patients diagnosis that results in an extra payment by Medicare. Those payments allegedly went to the companys Medicare Advantage plans.
Under Medicare Advantage, health insurance companies receive payments from the U.S. government to monitor and manage recipients benefits. If a patient has a certain diagnosis, the payments increase.
The Journal has been investigating the matter for several months and has interviewed a number of healthcare providers. The newspapers reporting claimed that Medicare paid UnitedHealth billions of dollars for questionable diagnoses.
The Journals previous reporting cited doctors who claimed UnitedHealth trained them to make revenue-producing diagnoses, some that were described as obscure or irrelevant.
According to the Journal, neither UnitedHealth nor any government agency has offered a comment on the report.
Posted: 2025-02-21 13:47:29
