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UnitedHealth probed by DoJ for potential Medicare fraud; shares slide - report
Seeking Alpha ^ | May 14, 2025 | Jonathon Block

Posted on 05/14/2025 6:00:31 PM PDT by gas_dr

UnitedHealth Group (NYSE:UNH) is under investigation by the Department of Justice for potential Medicare fraud.

The probe is centered around the insurer's Medicare Advantage business, The Wall Street Journal reported. UnitedHealth shares are down ~8% in after-hours trading Wednesday evening.

The healthcare-fraud unit at DoJ is spearheading the investigation. That division investigates transgressions such as kickbacks that lead to higher Medicare and Medicare payments, the newspaper noted.

The probe is the latest headache for the health insurance giant, which just had an unexpected CEO change on Tuesday.

Earlier this month, a group of shareholders sued the company alleging it hid the business impact from the backlash surrounding the murder of UnitedHealthcare CEO Brian Thompson.

(Excerpt) Read more at seekingalpha.com ...


TOPICS: Business/Economy; Crime/Corruption; News/Current Events
KEYWORDS:
UNH is awful. IMHO they should be shut down…
1 posted on 05/14/2025 6:00:31 PM PDT by gas_dr
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To: gas_dr
I believe that is AARP's health plan.

2 posted on 05/14/2025 6:03:41 PM PDT by Governor Dinwiddie ( O give thanks unto the Lord, for He is gracious, and His mercy endures forever. — Psalm 106)
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To: Governor Dinwiddie
I believe that is AARP's health plan.

I have the AARP/UHC Medicare advantage plan. Great plan. Hope it doesn't change

3 posted on 05/14/2025 6:09:27 PM PDT by FatherofFive (we mutually pledge to each other our lives, our fortunes, and our sacred honor)
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To: gas_dr

First Luigi Mangioni, then the stock cratering, then the CEO stepping down, now this.

A cynic would wonder if they’re all related.


4 posted on 05/14/2025 6:13:19 PM PDT by grey_whiskers (The opinions are solely those of the author and are subject to change without notice.)
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To: FatherofFive

The Medicare Advantage plan was at the heart of their scheme. They claimed their customers had all kinds of diseases they did not actually have, and collected huge additional payments from the government.


5 posted on 05/14/2025 6:15:21 PM PDT by proxy_user
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To: FatherofFive

Same here. Never had an issue.


6 posted on 05/14/2025 6:16:22 PM PDT by Labyrinthos
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To: gas_dr

They’re ALL into medicare fraud. Medicare advantage is a lucrative rip off.


7 posted on 05/14/2025 6:29:17 PM PDT by doc maverick
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To: grey_whiskers

Hardly cynical. UHC now employs docs and NPs through optum. I believe i read in February that the coders (not docs) were found upcoding. In addition UHC denies 2x as many claims as the other majors. UHC is as a company scum. Plain and simple. I hope the are barred from medicare.


8 posted on 05/14/2025 6:30:13 PM PDT by gas_dr (Conditions of Socratic debate: Intelligence, Candor, and Good Will)
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To: gas_dr

Now, it is time for the lawyers to make money off of the shareholder lawsuits.


9 posted on 05/14/2025 6:38:32 PM PDT by crusty old prospector
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To: FatherofFive

“I have the AARP/UHC Medicare advantage plan. Great plan. Hope it doesn’t change”

Same here. I have been on UHC for many years without problems. We will see if anything develops with this.


10 posted on 05/14/2025 6:49:49 PM PDT by plain talk
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To: gas_dr

Potential? Insurance companies scam. Double bill. My GF is a retired SGM. Army. Always juggling their BS.


11 posted on 05/14/2025 7:11:26 PM PDT by Hyman Roth
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To: Labyrinthos

“The Medicare Advantage plan was at the heart of their scheme. They claimed their customers had all kinds of diseases they did not actually have, and collected huge additional payments from the government.”

Sure, sure, whatever.

We’ll all patiently await the proof of your assertion.

In the meanwhile, I’ll take advantage of the BUYING OPPORTUNITY! :-)


12 posted on 05/14/2025 8:59:25 PM PDT by BB62
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To: gas_dr
UNH stock has cratered again after hours. Down 8% this evening.

The fraud and abuse investigation isn't new this week. I heard about it back in January.

13 posted on 05/14/2025 9:40:58 PM PDT by NautiNurse
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To: NautiNurse

I think this is a second investigation as well as it js now criminal.


14 posted on 05/15/2025 2:31:13 AM PDT by gas_dr (Conditions of Socratic debate: Intelligence, Candor, and Good Will)
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To: doc maverick
They’re ALL into medicare fraud. Medicare advantage is a lucrative rip off.

I see Cigna sold off its Medicare business at the end of last year. Wonder if they were given a heads up?

15 posted on 05/15/2025 2:37:43 AM PDT by Sirius Lee ("Never argue with a fool, onlookers may not be able to tell the difference.”)
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To: Sirius Lee; gas_dr
More than a year ago (March 26, 2024):

Medicare Advantage is overbilling Medicare by 22%

...The body in question is called the Medicare Payment Advisory Commission, or MedPac. It is an independent, authoritative body that advises Congress on Medicare. It was set up by the Balanced Budget Act of 1997, back when people in Washington were actually doing their jobs.

[Snip]

“We estimate that Medicare spends approximately 22 percent more for MA enrollees than it would spend if those beneficiaries were enrolled in FFS Medicare, a difference that translates into a projected $83 billion in 2024.”

In other words: The private insurers who now run more than half of all Medicare plans are overcharging the taxpayers by a staggering $83 billion a year. They are charging us taxpayers 22% more than it would cost us to provide the same health insurance to seniors directly, if we just cut out the private insurance companies as middlemen.

And that’s not because the people in Medicare Advantage are sicker and therefore should cost more anyway. MedPac says this 22% estimate is after accounting for “favorable selection” and “coding intensity” — technical Medicare terms that mean, in effect, who’s sicker.

It’s a rip-off, pure and simple. And that figure, $83 billion, is staggering.

To put it in context, that is nearly 10% of the entire Medicare budget.


16 posted on 05/15/2025 5:04:24 AM PDT by NautiNurse
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To: doc maverick
May 14, 2025 Marketwatch Opinion: RFK Jr. says he ‘loves’ Medicare Advantage. Uh-oh.
17 posted on 05/15/2025 6:33:23 AM PDT by NautiNurse
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To: BB62

I think you intended to respond to Post No. 5 — not my post No. 6.


18 posted on 05/15/2025 6:56:01 AM PDT by Labyrinthos
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