UnitedHealth Group Affirms Medicare Advantage Compliance Amid WSJ Reporting
UnitedHealth Group reaffirmed the integrity and compliance of its Medicare Advantage business in response to critical reporting by The Wall Street Journal. The company emphasized that its operations are governed by stringent federal regulations and are subject to rigorous oversight by the Centers for Medicare & Medicaid Services (CMS), ensuring transparency and adherence to CMS requirements. Independent audits by CMS have recognized UnitedHealth Group for having among the most accurate coding practices in the industry, underscoring its commitment to regulatory compliance.
The company highlighted the conclusion of a decade-long Department of Justice review that found no evidence of overpayment or wrongdoing associated with its Medicare Advantage plan. UnitedHealth Group supports comprehensive audits across all Medicare Advantage plans annually to foster confidence among stakeholders and counter misinformation about overpayments in the program. The organization employs certified clinical professionals and robust quality assurance measures to maintain high standards in its operations.
Expanding its compliance initiatives, UnitedHealth Group announced plans to implement regular, independent third-party coding oversight and audits to complement its existing quality assurance processes. This move aims to enhance stakeholder confidence in the accuracy and legitimacy of its Medicare Advantage reimbursements. The company remains focused on delivering improved health outcomes, enhanced benefits, and cost efficiencies to its members.
UnitedHealth Group positions itself as a leading health care and well-being company consisting of two main businesses: Optum and UnitedHealthcare. The organization operates with a mission centered on improving access, affordability, outcomes, and experiences within the health system through innovation and compliance. By fostering an inclusive and diverse workforce, the company aims to better serve consumers, care providers, and shareholders as part of its strategic vision.