Medicare Advantage Plans and UnitedHealth Group: $4.2 Billion Oversight

Thursday, 24 October 2024, 14:35

Medicare Advantage plans are facing scrutiny over $4.2 billion in payments tied to questionable home visits. UnitedHealth Group stands out as the biggest recipient, raising concerns about the legitimacy of health assessments used. A recent report highlights significant taxpayer costs linked to these practices.
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Medicare Advantage Plans and UnitedHealth Group: $4.2 Billion Oversight

Medicare Advantage Plans and Controversial Payments

Medicare Advantage plans have reportedly collected $4.2 billion in extra payments last year, mainly due to home visits aimed at diagnosing serious health issues among senior citizens. A new government report from the Office of Inspector General highlights concerns surrounding health risk assessments (HRAs) and their potential misuse, implying a significant financial impact on taxpayers.

UnitedHealth Group's Major Role

Among the players, UnitedHealth Group emerged as the largest beneficiary, receiving $3.7 billion from risk-adjusted payments, while Humana followed with $1.7 billion. This analysis raises eyebrows as approximately 1.7 million Medicare Advantage enrollees participated in these home visits without subsequent medical action, suggesting that the payments could be questionable.

Concerns for Taxpayers

  • Serious health condition assessments received no follow-ups
  • Potential misuse of HRAs indicated in the report
  • Taxpayer spending linked to these practices is alarming

As the scrutiny intensifies, the implications for the Medicare programs and private insurers like UnitedHealth Group warrant significant attention from stakeholders, politicians, and taxpayers alike.


This article was prepared using information from open sources in accordance with the principles of Ethical Policy. The editorial team is not responsible for absolute accuracy, as it relies on data from the sources referenced.


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