Fred Schulte
Senior Correspondent at KFF Health News
Senior Correspondent:@KFFHealthNews, veteran investigative journalist, author of Fleeced! and Gibson ES-125 player. (Ex-@publicintegrity @baltimoresun)
Articles
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1 month ago |
minnesotareformer.com | Fred Schulte |Minnesota Reformer
The Justice Department’s years-long court battle to force UnitedHealth Group to return billions of dollars in alleged Medicare Advantage overpayments hit a major setback Monday when a special master ruled the government had failed to prove its case. In finding for UnitedHealth, Special Master Suzanne Segal found that the DOJ had not presented evidence to support its claim that the giant health insurer exaggerated how sick patients were to illegally pocket more than $2 billion in overpayments.
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1 month ago |
yahoo.com | Fred Schulte
The United Healthcare corporate headquarters on Dec. 4, 2024, in Minnetonka, Minnesota. (Photo by Stephen Maturen/Getty Images)The Justice Department’s years-long court battle to force UnitedHealth Group to return billions of dollars in alleged Medicare Advantage overpayments hit a major setback Monday when a special master ruled the government had failed to prove its case.
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Dec 22, 2024 |
alternet.org | Fred Schulte
A western New York health insurance provider for seniors and the CEO of its medical analytics arm have agreed to pay a total of up to $100 million to settle Justice Department allegations of fraudulent billing for health conditions that were exaggerated or didn’t exist. Independent Health Association of Buffalo, which operates two Medicare Advantage plans, will pay up to $98 million.
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Dec 20, 2024 |
kffhealthnews.org | Fred Schulte
A western New York health insurance provider for seniors and the CEO of its medical analytics arm have agreed to pay a total of up to $100 million to settle Justice Department allegations of fraudulent billing for health conditions that were exaggerated or didn’t exist. Independent Health Association of Buffalo, which operates two Medicare Advantage plans, will pay up to $98 million.
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Nov 22, 2024 |
kffhealthnews.org | Fred Schulte
Medicare officials are pushing back against a federal watchdog’s call to crack down on home visits by Medicare Advantage health plans — a practice the watchdog says may waste billions of tax dollars every year. In late October, a Health and Human Services inspector general audit found that the insurers pocketed $7.5 billion in 2023 from diagnosing health conditions that prompted no medical services — about $4.2 billion of it through the health assessments done in patients’ homes.
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Seems there's no end to Medicare Advantage False Claims Act frauds. Here's another multimillion settlement https://t.co/4q4p1cTi1x
Just kicking the (alleged) upcoding can down the road. New filing in $2 billion Justice Department fraud case against UnitedHealth Group seeks trial in July 2026--some 15 years after whistleblower filed case.
Special Master finds $2 billion Justice Department fraud suit against UnitedHealth Group “depends entirely on speculation and assumptions” and recommends dismissal. Huge setback for government https://t.co/gfzAX1jKKn