UnitedHealth (UNH) stock was lower today on reports that it was being investigated by the U.S. Justice Department over its Medicare billing practices.
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Employees Questioned
As reported by the Wall Street Journal, the department’s criminal healthcare-fraud unit is probing how UnitedHealth deployed doctors and nurses to gather diagnoses that bolstered its payments.
The paper first reported back in May that an investigation by the department into the Medicare business had already begun, but these new details were a further blow to UnitedHealth.
Former UnitedHealth employees have reportedly been questioned by prosecutors working for the healthcare-fraud unit. The Federal Bureau of Investigation and the Department of Health and Human Services’ Office of Inspector General also participated in some of the interviews.
It is alleged that UnitedHealth’s efforts to encourage the documentation of certain lucrative diagnoses included testing patients, implementing procedures to ensure that medical conditions were captured, and sending nurses to patients’ homes.
Practices Review
UnitedHealth CEO Stephen Hemsley has said the company will review its practices for documenting payment-triggering diagnoses.
In Medicare Advantage, the program through which private insurers administer the benefits of the federal program for seniors and the disabled, the companies are paid more if their enrollees have certain health conditions.
A UnitedHealth spokesman said that the company welcomes “regular reviews of our policies and practices.”
This is another blow to the UnitedHealth stock, which is down 39% over the last 6 months.
This has included the murder of chief executive Brian Thompson in New York last December, and his replacement Andrew Witty departing for personal reasons.
Is UNH a Good Stock to Buy Now?
On TipRanks, UNH has a Moderate Buy consensus based on 18 Buy, 7 Hold and 1 Sell ratings. Its highest price target is $440. UNH stock’s consensus price target is $361.91 implying a 19.16% upside.
