Senate report says UHG used ‘aggressive strategies’ to increase MA payments
A Senate Judiciary Committee report released Jan. 12 found that UnitedHealth Group used “aggressive strategies” to maximize its Medicare Advantage risk-adjustment scores and collect higher payments from diagnoses of MA enrollees. The report said that UHG appeared to leverage its size, vertical integration and data analytics to stay ahead of CMS’ efforts to counteract unnecessary spending related to coding practices. “After a review of the records, this report provides evidence that shows UHG has turned risk adjustment into a major profit centered strategy, which was not the original intent of the program,” the report said.
Related News Articles
Headline
The AHA today released its Health Care Plan Accountability Update, covering the latest developments in Medicare Advantage, legislation and…
Headline
UnitedHealth Group announced plans to expand its Rural Payment Acceleration Pilot to reduce Medicare Advantage payment processing times for…
Perspective
Few patient populations are more vulnerable to the shifting winds around health care today than Medicare beneficiaries who need specialized, high-acuity and…
Headline
The Centers for Medicare & Medicaid Services April 6 released the Medicare Advantage and Part D Rate Announcement for calendar year 2027. The rate…
Headline
The Centers for Medicare & Medicaid Services April 2 released a final rule on policy and technical changes to Medicare Advantage, the Medicare Prescription…
Headline
The Centers for Medicare & Medicaid Services March 30 announced that C2C Innovative Solutions will replace Maximus in reviewing and processing appeals of…