Senator Grassley takes on UnitedHealth Medicare Advantage overpayments

One moderate Republican Senator is concerned about the billions of dollars in government overpayments to UnitedHealth Medicare Advantage. Senator Chuck Grassley, who chairs the Senate Judiciary Committee, sent UnitedHealth CEO Andrew Witty a letter demanding that he release information on the company’s Medicare Advantage government billing practices.

Countless reports and analyses show that the big Medicare Advantage insurers are overbilling Medicare to the tune of as much as $140 billion a year. The Medicare Payment Advisory Commission more conservatively estimates $83 billion in overpayments last year alone. But UnitedHealth won’t acknowledge that engaging nurses to add diagnoses to their enrollees’ medical records, even when the nurses have no clue what the diagnoses mean and perform no additional tests to determine additional diagnoses, is at the very least wrong, if not outright fraud.

Senator Grassley wants UnitedHealth to provide Congress will lots of information about their billing practices. Grassley alleged apparent fraud, waste and abuse at UnitedHealth. In 2021, UnitedHealth allegedly benefited to the tune of $8.7 billion from overbilling the government.

“Despite these oversight efforts, [Medicare Advantage Organizations] continue to defraud the American taxpayer, costing them billions of dollars a year … The apparent fraud, waste, and abuse at issue is simply unacceptable and harms not only Medicare beneficiaries, but also the American taxpayer,” Grassley wrote. Everyone with Medicare pays higher Part B premiums as a result of the overpayments, and the overpayments are eating into the Medicare Trust Fund.

Grassley wants Congress to examine UnitedHealth’s training manuals, guidance documents, compliance program details, audit results and other documents.

To be clear, UnitedHealth is the largest Medicare Advantage insurer and, consequently, likely to be reaping the greatest amount in overpayments. But, Humana, CVS Health and Anthem are also beneficiaries of these overpayments. According to the Congressional Budget Office, ending these overpayments would mean $1 trillion in savings over the next ten years.

Here’s more from Just Care:

• 33 experts call on CMS to continue reining in Medicare Advantage overpayments
• Congress could end overpayments to big insurers in Medicare Advantage and save $1 trillion, without gutting Medicaid
• UnitedHealth’s denials of critical rehab services is under investigation
• What’s more dangerous than dozens of insurers offering Medicare Advantage? UnitedHealth for All
• Doctors and hospitals face increasing claims denials