The
federal
government
has
been
cracking
down
on
healthcare
giant
UnitedHealth
Group
over
the
past
year,
and
it’s
showing
no
signs
of
slowing
down.
For
instance,
the
Department
of
Justice
began
an
antitrust
probe
into
the
company
last
February,
and
then
in
March,
HHS
launched
an
investigation
into
the
catastrophic
cyberattack
suffered
by
UnitedHealth
subsidiary
Change
Healthcare.
The
DOJ
also
filed
a
lawsuit
to
block
the
UnitedHealth
Group’s
$3.3
billion
acquisition
of
Amedisys
in
November.
This
week,
the
company
faced
two
new
investigations
from
federal
lawmakers
—
the
first
being
a
senator’s
probe
into
its
Medicare
Advantage
billing
practices,
and
the
second
being
a
congressman’s
investigation
into
a
decline
in
care
quality
at
UnitedHealth-owned
clinics
in
New
York.
The
first
new
probe
came
on
Monday,
when
Senator
Chuck
Grassley
(R-Iowa)
initiated
an
inquiry
into
UnitedHealth
Group’s
Medicare
Advantage
billing.
He
was
prompted
by
reporting
from
The
Wall
Street
Journal,
which
suggested
the
company
may
have
manipulated
billing
rules
for
profit.
The
report
stated
the
DOJ
is
investigating
the
company
for
inappropriately
inflating
its
members’
diagnosis
codes
to
increase
reimbursement
payments.
UnitedHealth
accused
The
Wall
Street
Journal
of
spreading
misinformation
and
denied
any
fraudulent
activity.
The
company
also
denied
that
the
DOJ
launched
an
investigation
into
its
Medicare
Advantage
billing
practices.
Grassley
has
requested
detailed
records
from
UnitedHealth
CEO
Andrew
Witty,
including
compliance
documents
and
training
manuals,
to
assess
the
company’s
billing
practices.
The
next
probe
came
on
Wednesday,
when
Representative
Pat
Ryan
(D-New
York)
launched
a
community
inquiry
into
care
quality
at
clinics
owned
by
UnitedHealth
subsidiary
Optum.
The
probe,
which
targets
Optum-owned
clinics
in
New
York’s
Hudson
Valley,
comes
as
a
result
of
constituent
complaints
about
inaccessibility,
inaccurate
billing,
and
a
reduction
in
care
quality.
“My
office
has
been
hearing
from
folks
across
the
Hudson
Valley
about
a
decline
in
care,
especially
at
CareMount
Medical
and
Crystal
Run
Healthcare,
following
their
purchase
by
Optum.
I’m
launching
this
community
inquiry
to
hear
from
as
many
folks
as
possible
to
directly
inform
my
ongoing
oversight,”
Ryan
said
in
a
statement.
The
congressman
is
seeking
more
feedback
from
his
constituents
who
receive
care
or
work
at
Optum
facilities
in
the
Hudson
Valley.
Optum
is
looking
forward
to
meeting
with
policymakers
to
discuss
ways
to
achieve
the
“common
goal
of
providing
the
highest
quality
patient
care,”
a
company
spokesperson
wrote
in
an
email
to
MedCity
News.
“Since
these
practices
chose
to
join
Optum,
we
have
introduced
a
number
of
new
measures
to
continue
to
enhance
our
services,
including
dedicated
teams
responsible
for
scheduling
and
supporting
medication
refills
and
clinical
questions,
as
well
as
technology
investments
to
improve
our
patients’
experiences.
We,
too,
have
felt
the
impact
of
the
national
healthcare
provider
shortage
and
are
continuing
to
invest
in
solutions
to
attract,
support
and
retain
our
dedicated
care
providers,”
the
spokesperson
wrote.
Photo:
MikeyLPT,
Getty
Images
Note:
This
article
was
updated
February
28
to
include
commentary
from
Optum.