UnitedHealth Group collected far more than any other Medicare health insurer in risk-adjustment payments in 2017 that were based on questionable billing practices, a federal agency disclosed, the Star Tribune reports.
The finding puts the Minnetonka, MN-based health care giant at the center of a controversy over whether health insurers use data from patient chart reviews and health risk assessments in ways that grant them improper payments from the federal Medicare program.
Investigators at the Office of Inspector General (OIG) at the U.S. Department of Health and Human Services have said they’re concerned that insurers with Medicare Advantage health plans might be using the risk assessments, in particular, to game the system.
Whistleblower lawsuits have alleged that UnitedHealth Group and others have wrongly used data from chart reviews to boost Medicare payments — an industry-wide concern also raised previously by OIG. Read more.
