Datapoint: DOJ Reportedly Investigating United’s MA Practices

The U.S. Dept. of Justice (DOJ) has reportedly launched an antitrust investigation into UnitedHealth Group that includes an examination of its Medicare Advantage risk coding practices. According to a Wall Street Journal report citing unnamed people familiar with the matter, the DOJ has been seeking information such as how UnitedHealthcare interacts with provider groups acquired by its Optum division in recent years. Regulators are also looking into MA billing issues, “including the company’s practices around documenting patients’ illnesses.” With 9.3 million members, UnitedHealthcare is by far the largest MA insurer in the U.S. It grew 1.6% during the latest Medicare Annual Election Period, a noticeable slowdown from previous years.

Source: AIS’s Directory of Health Plans

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AIS Health Staff

AIS Health Staff

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