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Mike Blake | Reuters
Unitedhealthcare is back in hot water, since the insurance giant is characterized by a registered state examination of its Medicare -Billing practices, pursues employees and potential layoffs and publicly speaks together with the billionaire Bill Ackman.
These developments in the past few days extend a turbulent year for his parent company. Unitedhealth GroupCharged by the murder of a top manager, an expensive cyber attack against his subsidiary and high medical costs in his low insurance. The Unitedhealth Group is the largest health conglomerate in the USA, based on sales and market capitalization of more than $ 420 billion, and Unitedhealthcare is the largest private insurer.
The Unitedhealth Group's shares have fallen around 23% in the past three months.
The share also fell by 9%on Friday after a report on the probe, which was first reported by the Wall Street Journal. The Ministry of Justice has initiated an investigation of civil fraud in the Billing practices of Unitedhealth for its Medicare Advantage plans in recent months.
The probe expressly examines whether the diagnoses have been routinely made to trigger additional payments in these plans, including the insurer's groups that the insurer has, said the journal. According to a series of articles from the newspaper last year, the reported that Medicare Unitedhealth paid billions of dollars for questionable diagnoses.
Medicare Advantage plans are offered by private insurers who receive a defined rate to manage health care for seniors who are looking for additional advantages that are not covered with traditional medicar. These plans were a source for high medical costs in the wider insurance industry last year.
In an explanation, Unitedhealth referred to the reporting “misinformation” of the journal and said
“Every proposal that our practices are fraudulent are emphasized and wrong,” said the company.
In a research note on Friday, the RBC Capital Markets analyst Ben Hendrix described the reported investigation as a “incremental overhang”, but emphasized that this is probably a “lengthy process and is unlikely that it will lead to substantial financial headwind at short notice “. He pointed out an investigation that the DOJ had launched the company of the company last year due to potential violations of antitrust law, which will also have an extended timeline before each solution.
Reports about the probe took place two days after CNBC had first reported that Unitedhealthcare offered the employees Buyouts and could pursue layoffs if resignation rates were not fulfilled. The move comes when the company tries to reduce costs through efforts such as the use of digital technology.
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And at the beginning of this month, Ackman, one of the best -known investors in the world, publicly promised the legal costs for a Texan doctor in a dispute with Unitedhealth Group because of their claims that the company had pulled them out of an operation to provide the care of a patient justify.
Ackman, CEO of Pershing Square Capital Management, later took a position to X that criticized the insurer after the lawyers of Unitedhealth had informed him that the doctor's claim that he had intensified on social media was untrue. Ackman said he had no position in Unitedhealth.
One of his earlier places about the dispute asked the US Securities and Exchange Commission to examine the company and suggested that the insurer's profitability is massively overrated due to its rejection of medically necessary procedures “.
This is similar to the public setback, which the company was confronted in December in December after the CEO was murdered by Unitedhealthcare. It unleashed a wave of pent -up anger and resentment against the insurance industry and called for reforms to prevent nursing stretches.
Unitedhealth is still composed of the failures of a cyber attack in his side change speed, which processes the medical claims. The cyber attack affects the protected health information of around 190 million people, and Unitedhealth has paid more than 3 billion US dollars to affected providers.
Unitedhealth has announced that the cyber attack became aware a year ago until the day on Friday.
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