Ocasio-Cortez calls for expanded UnitedHealth investigation after nursing home report

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Reps. Alexandria Ocasio-Cortez and Lloyd Doggett have asked U.S. Attorney General Pam Bondi to expand the Justice Department’s reported civil and criminal investigations into UnitedHealth Group to include allegations that the company has engaged in harmful and fraudulent cost-cutting tactics in nearly 2,000 nursing homes.

In May, The Guardian reported that UnitedHealth incentivized nursing homes nationwide to avoid medically necessary hospital transfers for its member residents, with some cases resulting in permanent harm to patients. The outlet said it reviewed thousands of confidential corporate and patient records, and interviewed more than 20 current and former UnitedHealth and nursing home employees. The report also included two federal whistleblower complaints filed in May.

UnitedHealth has denied the allegations, saying that the claims are false and have caused significant reputational damage. The company has also filed a defamation lawsuit against The Guardian, alleging that the outlet edited internal emails and selectively used sources to craft a misleading narrative.

“The potential harm of UnitedHealth’s business practices extends far beyond waste of taxpayer dollars and appears to be endangering enrollees and harming health outcomes,” Reps. Ocasio-Cortez and Doggett wrote June 9. “We strongly urge you to expand your ongoing investigations to include the allegations outlined in The Guardian and other appropriate lines of inquiry concerning the impact of UnitedHealth’s business practices on patients.”

The Guardian also reported that UnitedHealth paid thousands in bonuses to nursing homes to prevent the transfer of residents to hospitals and coerced residents into signing “do not resuscitate” orders as a cost-saving measure, even when those residents had expressed a desire for life-saving care. According to the report, the company also offered bonus payments to nursing homes for residents enrolled in “Institutional Special Needs Plans,” a type of Medicare Advantage plan designed for people who need long-term care in a facility.

“The U.S. Department of Justice investigated these allegations, interviewed witnesses and obtained thousands of documents that demonstrated the significant factual inaccuracies in the allegations,” UnitedHealth Group said in a May statement responding to the report. “After reviewing all the evidence during its multi-year investigation, the Department of Justice declined to pursue the matter.”

Last month, it was reported that the Department of Justice opened up a criminal investigation into UnitedHealth Group for possible Medicare fraud. The lawmakers request Attorney General Bondi expand the DOJ’s current investigation to include new allegations that UnitedHealth Group has engaged in the following business practices regarding the Medicare Advantage Program:

UnitedHealth is facing at least three investigations from the Justice Department, including a reported criminal probe regarding alleged Medicare Advantage fraud, per The Wall Street Journal.

UnitedHealth has said that it stands “by the integrity of our Medicare Advantage program.”

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