Minnesota-based UnitedHealthcare overbilled Medicare by $47 million: HHS
A federal audit has found that UnitedHealthcare, the country’s largest health insurance company by revenue, likely inflated its Medicare billing claims by at least $46.9 million between 2020 and 2021.
TL;DR
- A federal audit by HHS OIG found UnitedHealthcare likely inflated Medicare billing claims by at least $46.9 million between 2020-2021.
- The insurer allegedly upcoded diagnoses for conditions like strokes, embolisms, and cancers.
- Most medical records analyzed did not support the diagnostic codes submitted to CMS.
- UnitedHealthcare disputed the audit's findings, calling the methodology 'fundamentally flawed' and the sample size too small.
- The audit is part of a series of reviews of Medicare Advantage plans, with a previous audit of HumanaChoice finding $130.9 million in overpayments.