Tag Archives: unitedhealthcare

Lawsuit claims UnitedHealthcare concealed Medicare Advantage enrollment fraud complaints

Joseph Burns

About Joseph Burns

Joseph Burns (@jburns18), a Massachusetts-based independent journalist, is AHCJ’s topic leader on health insurance. He welcomes questions and suggestions on insurance resources and tip sheets at joseph@healthjournalism.org.

Credit: Kaiser Family Foundation
UnitedHealthcare has 4.6 million Medicare Advantage members, 24 percent of the U.S. Medicare Advantage market.

A recently unsealed whistleblower lawsuit claims that UnitedHealthcare concealed from federal officials hundreds of complaints of enrollment fraud and other misconduct in its Medicare Advantage program.

Brought by two UnitedHealthcare sales professionals in Wisconsin, this suit is worth watching because it is the third in recent months that whistleblowers have brought using knowledge they gained while working for Minnetonka, Minn.-based health insurance giant. Continue reading

CPI: Insurers prepare $20 mil lobbying effort

Andrew Van Dam

About Andrew Van Dam

Andrew Van Dam of The Wall Street Journal previously worked at the AHCJ offices while earning his master’s degree at the Missouri School of Journalism.

On the Center for Public Integrity’s PaperTrail blog, Peter Stone reports that five of biggest insurers in America are preparing to go to the mat for round two, this time with the intertwined goals of swinging midterm elections and influencing health reform implementation regulations.

According to Stone, Aetna, Humana, United HealthCare, WellPoint and (maybe) Cigna will pool something like $20 million. Look for the new lobbying organization, probably a 501(c) (4) nonprofit, in the next few months. Television ads and a variety of other campaigns will likely follow.

Lewin group linked to private insurers

Andrew Van Dam

About Andrew Van Dam

Andrew Van Dam of The Wall Street Journal previously worked at the AHCJ offices while earning his master’s degree at the Missouri School of Journalism.

In the Columbia Journalism Review, Trudy Lieberman, president of AHCJ’s board of directors, scolded journalists for not mentioning that Lewin Group, the consultants who released a recent study claiming that a public insurance option would cost doctors and hospitals money, is ultimately part of a major insurance company.

(Lewin Group is) part of Ingenix, which is owned by United Healthcare Group, the insurance behemoth that has been buying up insurance companies left and right, expanding its reach into just about every segment of the health-insurance market. Its flagship, UnitedHealthcare, helps make it the largest health insurer in the country. It’s a safe bet that United is not too keen on a public plan that might shrink its business.

The relationship is disclosed in the study and Lieberman turned up evidence indicating that there may be no formal protections in place for Lewin Group’s editorial independence. She wondered why journalists, particularly those behind a widely used AP story, did not provide readers with any information or context on Lewin’s insurance industry ties and called on reporters to remedy their error next time Lewin Group comes up.