A tracker of healthcare giant UnitedHealth Group’s documented abuses of patients, independent medical practices and pharmacies.
UnitedHealth Group (UHG) is the largest healthcare conglomerate in the country, with over 2,300 different companies. Its business lines include health insurance, pharmacies, pharmacy benefits, surgery centers, primary care clinics, hospice agencies, mental health providers, and home health agencies. Through hundreds of acquisitions in recent years, UnitedHealth Group’s Optum Health subsidiary is now the largest employer of physicians in the country, with 90,000 physicians. Optum is also one of the big three pharmacy benefit managers (PBMs), controlling which drugs an insurance plan will cover. UHG also operates a data and analytics business, Optum Insight, which houses Change Healthcare, as well as its own bank, Optum Bank the second-largest provider of health savings accounts ($20 billion in assets).
Across these business lines, UnitedHealth Group has a history of denying claims for necessary procedures or medications, unfairly squeezing out independent physician practices and pharmacies, and fraudulently manipulating medical and patient data to maximize its profits.
ABUSE CATEGORIES:
- Patient Privacy Violation: UHG violates patient privacy by using their data without consent
- Upcoding and Overbilling: UHG has a history of upcoding–submitting medical codes to federal programs for more serious and more expensive diagnoses or procedures than what was necessary, diagnosed, or performed. As a result, UHG overbills the federal government, wasting millions in taxpayer dollars.
- Denial of Care: UHG will deny patients the care they need in order to reduce costs and boost company revenue. This includes ignoring medical advice from UHG providers.
- Anticompetitive Steering of Patients and Providers: UHG’s size, vertical integration, and market power allow the company to utilize anticompetitive tactics to steer patients to UHG owned providers for care, and illegally require practices not to compete for physicians.
According to our calculations, UHG has been accused of engaging in the following activities in the past seven years:
- Two reports and one lawsuit for violating patient privacy;
- Seven reports and three lawsuits for upcoding and overbilling the federal government;
- Seven reports and five lawsuits for denying patient care based on cost instead of medical necessity, and
- Eight reports and seven lawsuits for steering patients and providers toward UHG owned subsidiaries in order to increase company profits.
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This data was last updated April 11, 2024.