As UnitedHealthcare faces scrutiny in the wake of the murder of its CEO, Brian Thompson, last month, a group of shareholders is asking the firm to examine how its claims policies and business practices impact public health and access to care.
Becker’s Payer Issues reported on the proposal submitted January 8 by the Interfaith Center on Corporate Responsibility, a coalition of more than 300 institutional investors. The proposal asks UnitedHealthcare to prepare a report on its practices that limit or delay access to healthcare. The request says the firm’s prior authorization policies and other business practices designed to increase short-term value may risk the company’s brand name.
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"Our proposal suggests some introspection by [UnitedHealth] that will help the company and all its stakeholders thrive," said Timnit Ghermany, director of the Northwest Coalition for Responsible Investment.
Thompson’s death has prompted debate and outrage across the country about healthcare costs and claims denials. Stories detailing specific cases have emerged in various outlets. For example, a surgeon was reportedly interrupted during a procedure by a UHC representative asking if her patient’s overnight stay was necessary. Dr. Elisabeth Potter described the encounter in a post on TikTok, saying the insurance industry is “out of control.”
In an investigation about denial of claims, the New York Times cited a 2023 lawsuit against UHC by a college student who accumulated millions in medical claims to treat a severe case of ulcerative colitis. The lawsuit said UHC disregarded a report that deemed the expensive treatments as necessary. UHC settled for an undisclosed amount but said it reviewed treatment plans based on clinical guidelines to ensure patient safety.
Amid the uproar, UHC parent UnitedHealth Group issued a statement in December saying it pays about 90% of claims upon submission. Of those that require further review, around 0.5% are due to medical or clinical reasons, the firm said.
“Highly inaccurate and grossly misleading information has been circulated about our company’s treatment of insurance claims,” the statement said.
Private insurers are generally not required to publish data about claims denial rates. However, a Senate committee investigation determined that UnitedHealthcare denied requests for nursing home stays for patients recovering from falls and strokes three times more often than it did for other services. Humana and CVS were also scrutinized during the investigation. The company also is the subject of a class-action lawsuit claiming the company uses an algorithm to deny care for certain patients, an assertion the company denies, according to the NYT article.
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