UnitedHealth faces probes of nursing home, Medicare pay

UnitedHealth Group is facing legal challenges on multiple fronts, including federal investigations into its Medicare billing practices and calls for a congressional investigation into its nursing home payment practices.

The healthcare insurance giant confirmed in late July it is the subject of criminal and civil investigations into its Medicare billing practices by the US Department of Justice and denied any allegations of wrongdoing.

The company said it reached out to the DOJ after reviewing media reports about investigations of its Medicare billing practices and has begun complying with formal civil and criminal requests from the department.

"The company has full confidence in its practices and is committed to working cooperatively with the department throughout this process," UnitedHealth Group said in a statement provided to McKnight's LongTerm Care News. "The company has a long record of responsible conduct and effective compliance."

Meanwhile, two high-ranking US Senators, Ron Wyden (D-OR) and Elizabeth Warren (D-MA), have called for a "major" investigation into the company's nursing home business practices.

In a letter, Wyden and Warren cited "aggressive" strategies by the company to lower nursing home costs, including allegations the company offered incentives to facilities to avoid medically necessary hospital transfers of residents.

The company responded in a statement that it had received the senators' letter and said the allegations stem from a media report that "misrepresents" its |-SNP Medicare Advantage program for skilled nursing residents.

"We stand firmly behind the integrity of our I-SNP program, which consistently receives high satisfaction marks," the company statement said. "The US Department of Justice extensively reviewed these allegations and found no evidence of wrongdoing."