In a New York Times fluff piece, the head of the UnitedHealth Group, Andrew Witty, attempts to make the case that his company does not deserve to be maligned. (Here’s my letter to the New York Times in response. The American Economic Liberties Project has been tracking the publicly recorded illegal and wrngful conduct of UnitedHealth Group, including patient abuses, provider abuses and retail pharmacy abuses. UniteHealth Group (UHG) is the conglomerate that owns UnitedHealth insurance as well as more than 2,300 other companies. It is the biggest health care corporation in the country.
The types of companies that UHG owns include pharmacies, health insurers, pharmacy benefit managers, primary care and mental health providers, surgery clinics, home health and hospice agencies. Optum, one of UHG’s subsidiaries, employs 90,000 physicians, more than any other company. It is also one of the three biggest PBMs, which design formularies for insurance companies, choosing the drugs and patient copays.
UHG’s ownership of all these lines of business allows it to game the health care system in all sorts of ways to maximize profits and squeeze smaller companies out of business.
What types of abuses has UHG subsidiaries been found to engage in?
- Overcharging: The Medicare Payment Advisory Commission (MedPAC), the Committee for a Responsible Federal Budget (CRFB), and many other organizations have reported that each year UHG and other large insurers charge the government more than they should for the services they deliver. This year alone, overcharges amounted to somewhere between $83 billion and $140 billion. 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 billions in taxpayer dollars.
- Denials of care: The data show that UHG denies one out of every three requests for coverage, keeping patients from getting the care they and their treating physicians believe they need. They overrule their own network physicians in order to spend less on care and maximize profits.
- Anticompetitive behaviors: Because UHG owns so many health-related companies, it can and does steer patients and physicians to the products and services their companies deliver.
- Patient privacy violations: UHG uses patient data without patient consent, violating patient privacy.
Over the last seven year, UHG has been charged with engaging in these activities:
- Eight reports and three lawsuits for overcharging the federal government.
- 10 reports and five lawsuits for denying patient care because of the cost rather than medical necessity.
- Eight reports and seven lawsuits for steering patients and providers to companies that UHG owns.
- Three reports of corrupt practices.
- Two reports and one lawsuit for violating patient privacy.
For more information on UHG abuses, visit violationtracker.org.
Here’s more from Just Care:
- What’s more dangerous than dozens of insurers offering Medicare Advantage? UnitedHealth for All
- UnitedHealth care delays, denies and grows ever bigger
- Hospitals, physicians and pharmacies left unpaid after a UnitedHealth cyberattack
- UnitedHealth’s denials of critical rehab services is under investigation
- Traditional Medicare v. Medicare Advantage? Different as night and day