UnitedHealth Used Aggressive Diagnosing Strategy to Boost Federal Funding for Medicare Advantage: Senate Report

UnitedHealth Group uses aggressive tactics to maximize federal payments by capturing high-paying, often discretionary, medical diagnoses, according to a report by the Senate Judiciary Committee. The insurer uses high-tech scanners and a team of specialists to identify problems in enrollees—including minor ones—to ensure the insurer obtains the maximum funding possible, even if that money is not used to treat the added diagnoses, according to the Jan. 12 report. Medicare Advantage is an alternative to traditional Medicare that is operated by commercial insurance companies, which are paid a fixed monthly fee per person based on the health condition of the enrollee. The provision of additional funds for enrollees diagnosed with more expensive health conditions is called risk adjustment....