(VOR News) – Federal criminal and civil investigations are underway against UnitedHealth Group’s market-leading Medicare business. The company has stated that it is working with the investigating authorities.
Healthcare company contacts Justice Department on Thursday.
This comes after the company conducted an analysis of media stories concerning inquiries into specific sectors of its business. As stated in a filing with the Securities and Exchange Commission (SEC), “(UnitedHealth) has a long record of responsible conduct and effective compliance,” the business stated.
The Wall Street Journal reported at the beginning of this year that federal authorities had initiated a civil fraud investigation into the manner in which the company documents diagnoses that result in increased Medicare Advantage plan benefits.
Individuals who are 65 years of age or older are the primary beneficiaries of these private-run variants of the Medicare coverage program that is administered by the government.
The UnitedHealthcare division of the corporation, which is the largest supplier of Medicare Advantage plans in the US, provides coverage to more than 8 million individuals. Over the course of the most recent few quarters, the organization has been put under pressure as a result of increased utilization of care and rate decreases.
In a story that was published in February by The Journal, which quoted sources who wished to remain anonymous, it was stated that the investigation was centered on billing infractions that had occurred in the preceding several months.
Press reports that have been published since then indicate that a federal criminal health care fraud section is currently conducting an investigation into the manner in which the corporation utilized physicians and nurses to collect diagnoses that are used to substantiate payments.
In the document that was submitted on Thursday, UnitedHealth stated that it “has full confidence in its practices and is committed to working cooperatively with the Department throughout this process.”
UnitedHealth Group Limited is known for being the owner and operator of one of the most significant health insurance and pharmaceutical benefits management firms in the United States.
In addition to this, it hosts a booming Optum corporation that offers support and maintenance for information technology resources.
As a result of having a revenue that was greater than $400 billion the previous year, UnitedHealth was able to achieve the third spot on the Fortune 500 list of the most successful corporations in the United States.
In October of last year, its shares hit a record $630.
The share price, on the other hand, has significantly decreased since December, when UnitedHealthcare CEO Brian Thompson was shot and killed in midtown Manhattan when he was on his way to the annual investor conference of the firm. As previously stated, authorities have identified Luigi Mangione as the suspect responsible for the shooting.
Due to an increase in the utilization of health care services, the company’s forecast was reduced in the month of April, which further contributed to the decline in the share price.
A month later, former CEO Andrew Witty resigned, and the company completely abandoned its estimate, claiming that the medical expenses of new Medicare Advantage consumers were more than anticipated.
On Thursday afternoon, the stock price dropped by more than three percent, or $10.73, to a level of $281.78 during trading. Compared to the highest point it reached in November, this is a fifty-five percent decrease. A wide range of general indicators were available for use.
UnitedHealth will make the results of the second quarter public on Tuesday of the following week.
SOURCE: USN
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