UnitedHealth's headquarters in Minnetonka, Minnesota. Credit: wolterke/Adobe Stock;
UnitedHealth put out a statement Friday that rejected allegations by the Wall Street Journal that the health insurer is facing a new federal government investigation over Medicare Advantage billing practices.
The article, which was published behind a paywall and based on unnamed sources, indicated that the U.S. Justice Department was looking into reports that UnitedHealth had tried to make Medicare Advantage plan enrollees look sicker than they were, to improve risk-adjustment program performance.
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Investors reacted by causing UnitedHealth's share price to fall 7.17%, to $466.42.
UnitedHealth suggested that the Wall Street Journal has been favoring the old fee-for-service health care payment strategies over modern efforts to manage care.
Related: UnitedHealth's PBM will pass 100% of rebates on to clients: Will more big PBMs follow?
"The government regularly reviews all MA plans to ensure compliance, and we consistently perform at the industry's highest levels on those reviews," UnitedHealth said in the statement. "We are not aware of the 'launch' of any 'new' activity as reported by the Journal. We are aware, however, that the Journal has engaged in a year-long campaign to defend a legacy system that rewards volume over keeping patients healthy and addressing their underlying conditions."
For employers and benefits advisors, the clash is one more part of a surge in health care provider efforts to oppose health plan cost management efforts.
Some of the other components of the surge include pharmacy benefit managers' efforts to hold down prescription drug prices and physicians' efforts to restrict or eliminate health plans' use of prior authorization programs to manage care costs.
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Allison Bell
Allison Bell, a senior reporter at ThinkAdvisor and BenefitsPRO, previously was an associate editor at National Underwriter Life & Health. She has a bachelor's degree in economics from Washington University in St. Louis and a master's degree in journalism from the Medill School of Journalism at Northwestern University. She can be reached through X at @Think_Allison.
