Reports from the Centers for Medicare & Medicaid Services or major news outlets

WSJ Investigation Reveals $50 Billion in Extra Payments by Insurers, Including UnitedHealth Group, to Medicare Advantage (2019-2021)

Jan 4, 2025, 11:31 AM

A yearlong investigation by The Wall Street Journal has uncovered that private health insurers, including UnitedHealth Group, extracted approximately $50 billion in extra payments from the Medicare Advantage system between 2019 and 2021. The findings indicate that insurers diagnosed patients with conditions that did not receive treatment from any doctors, allowing them to claim these additional funds. The investigation highlights concerns over the practices of these insurers and raises questions about the effectiveness of oversight mechanisms in the Medicare system. Critics have pointed to previous proposals, such as the Medicare Public Option, which could have potentially mitigated these issues but were ultimately rejected by lawmakers. The investigation has sparked discussions about the broader implications of private health insurance practices on the healthcare system in the U.S.