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DOJ Investigates Medicare Billing Practices at UnitedHealth

53 points by Jimmc414 2y ago

redeux 2y ago
Actual fraud coming from a private company taking advantage of the US Government, which is how almost all fraud happens - not from the “deep state”
- rayiner 2y ago
  [flagged]
  - tanaros 2y ago
    It is difficult to investigate since the original statement of “$21 million for ‘voter turnout’ in India” doesn’t give any reference to the actual grant. Some sources suggest that the referenced grant is [0], as this is allegedly the only grant for $21 million by USAID that matches the description. It is for Bangladesh, not India, and the money appears to have gone to various pro-democracy advocacy groups. While I suppose you could argue about whether the US should “spread democracy” around the world, I don’t see that you can say this is fraud rather than merely government spending one disagrees with. [0] https://www.highergov.com/grant/72038822LA00001/ https://www.highergov.com/grant/72038822LA00001/
    - rayiner 2y ago
      As a Bangladeshi I’d say that’s worse. Regardless, calling it “pro-democracy” is the fraud. The government that was recently overthrown was elected with supermajorities since 2014. The PM had a 70% approval rating in 2023 in polling by the American IRI: https://www.cfr.org/blog/new-bangladesh-survey-hasina-remains-popular-opposition-support-and-public-discontent-are https://www.cfr.org/blog/new-bangladesh-survey-hasina-remain... There was no “democracy” problem. Instead, it was US funding to destabilize a government that was seen as too friendly to Russia. It’s classic Deep State fraud. In this case, a fraud that will have resulted in setting economic development backward a decade in a country of 175 million people. Far more costly than even $8 billion in UHC fraud.
      - redeux 2y ago
        You may not like it but a US agency advancing US interests is not fraud and there are no actual allegations of something that would meet the definition of fraud.
        rayiner 2y ago
        It’s literally fraudulent for an aid agency to be spending aid money fomenting overseas regime change. And it’s morally fraudulent because it doesn’t serve American interests. It serves the pecuniary and ideological interests of deep state/nat sec/liberal internationalist nutjobs deeply embedded in these institutions. America’s only interest in that region is suppressing Islamists, which the previous government was doing a great job at. It’s doubtful that, if the government was being transparent, Americans would pay money to overthrow the government that was killing Islamist radicals without due process in favor of one that’s likely to be taken over by Islamists.
        lesuorac 2y ago
        There seems to be a slight of hand going on here. The only grant listed in this thread [1] is for "International development and humanitarian assistance" with a sub function of "Consortium For Elections & Political Process Strengthening". There's no evidence shown that this grant money is being used to _overthrow_ a democratically elected government. Also, given that the initially 21 Million claim isn't actually backed up by a specific grant. It's more likely just a fraudulent claim by Musk and you should stop listening to him. I mean it's really trivial to list the grant when you canceled it ... [1]: https://www.highergov.com/grant/72038822LA00001/ https://www.highergov.com/grant/72038822LA00001/
        rayiner 2y ago
        You have to be gullible as shit—falling for the fraud—to think State Department funding for “democracy” in a third world country friendly to Russia isn’t for destabilizing the government.[1] If the shoe were on the other foot, foreign money being used to “fortify elections” in the U.S. you’d immediately see it for what it is. [1] https://www.dhakatribune.com/bangladesh/foreign-affairs/374429/trump-slams-29m-bangladesh-project-to-unknown https://www.dhakatribune.com/bangladesh/foreign-affairs/3744...
Jimmc414 2y ago
https://archive.is/mGLAY https://archive.is/mGLAY
Jimmc414 2y ago
UnitedHealth allegedly received $8.7 billion in extra federal payments in 2021 just for diagnoses that were never actually treated. Through their "HouseCalls" unit, each nurse visit triggered an average of $2,735 in additional government payments; just for documenting conditions, not treating them. UnitedHealth trained doctors to document revenue-generating diagnoses Used software to suggest profitable diagnoses Paid bonuses to providers who followed these suggestions Added diagnoses without lab tests or confirmation The same patients suddenly had many more lucrative diagnoses after joining UnitedHealth's Medicare Advantage plans versus before. When confronted, rather than addressing the specific allegations about billing practices, UnitedHealth called the WSJs reporting "outrageous and false" and claimed it was part of a "campaign against Medicare Advantage." The company seemingly built entire systems in a deliberate, systematic effort to maximize government payments rather than isolated incidents or honest mistakes.
impish9208 2y ago
Earlier: https://news.ycombinator.com/item?id=43127111 https://news.ycombinator.com/item?id=43127111

53 points by Jimmc414 2y ago

Actual fraud coming from a private company taking advantage of the US Government, which is how almost all fraud happens - not from the “deep state”

rayiner 2y ago
[flagged]
- tanaros 2y ago
  It is difficult to investigate since the original statement of “$21 million for ‘voter turnout’ in India” doesn’t give any reference to the actual grant. Some sources suggest that the referenced grant is [0], as this is allegedly the only grant for $21 million by USAID that matches the description. It is for Bangladesh, not India, and the money appears to have gone to various pro-democracy advocacy groups. While I suppose you could argue about whether the US should “spread democracy” around the world, I don’t see that you can say this is fraud rather than merely government spending one disagrees with. [0] https://www.highergov.com/grant/72038822LA00001/ https://www.highergov.com/grant/72038822LA00001/
  - rayiner 2y ago
    As a Bangladeshi I’d say that’s worse. Regardless, calling it “pro-democracy” is the fraud. The government that was recently overthrown was elected with supermajorities since 2014. The PM had a 70% approval rating in 2023 in polling by the American IRI: https://www.cfr.org/blog/new-bangladesh-survey-hasina-remains-popular-opposition-support-and-public-discontent-are https://www.cfr.org/blog/new-bangladesh-survey-hasina-remain... There was no “democracy” problem. Instead, it was US funding to destabilize a government that was seen as too friendly to Russia. It’s classic Deep State fraud. In this case, a fraud that will have resulted in setting economic development backward a decade in a country of 175 million people. Far more costly than even $8 billion in UHC fraud.
    - redeux 2y ago
      You may not like it but a US agency advancing US interests is not fraud and there are no actual allegations of something that would meet the definition of fraud.
      - rayiner 2y ago
        It’s literally fraudulent for an aid agency to be spending aid money fomenting overseas regime change. And it’s morally fraudulent because it doesn’t serve American interests. It serves the pecuniary and ideological interests of deep state/nat sec/liberal internationalist nutjobs deeply embedded in these institutions. America’s only interest in that region is suppressing Islamists, which the previous government was doing a great job at. It’s doubtful that, if the government was being transparent, Americans would pay money to overthrow the government that was killing Islamist radicals without due process in favor of one that’s likely to be taken over by Islamists.
        lesuorac 2y ago
        There seems to be a slight of hand going on here. The only grant listed in this thread [1] is for "International development and humanitarian assistance" with a sub function of "Consortium For Elections & Political Process Strengthening". There's no evidence shown that this grant money is being used to _overthrow_ a democratically elected government. Also, given that the initially 21 Million claim isn't actually backed up by a specific grant. It's more likely just a fraudulent claim by Musk and you should stop listening to him. I mean it's really trivial to list the grant when you canceled it ... [1]: https://www.highergov.com/grant/72038822LA00001/ https://www.highergov.com/grant/72038822LA00001/
        rayiner 2y ago
        You have to be gullible as shit—falling for the fraud—to think State Department funding for “democracy” in a third world country friendly to Russia isn’t for destabilizing the government.[1] If the shoe were on the other foot, foreign money being used to “fortify elections” in the U.S. you’d immediately see it for what it is. [1] https://www.dhakatribune.com/bangladesh/foreign-affairs/374429/trump-slams-29m-bangladesh-project-to-unknown https://www.dhakatribune.com/bangladesh/foreign-affairs/3744...

Jimmc414 2y ago

https://archive.is/mGLAY https://archive.is/mGLAY

Jimmc414 2y ago

UnitedHealth allegedly received $8.7 billion in extra federal payments in 2021 just for diagnoses that were never actually treated. Through their "HouseCalls" unit, each nurse visit triggered an average of $2,735 in additional government payments; just for documenting conditions, not treating them. UnitedHealth trained doctors to document revenue-generating diagnoses Used software to suggest profitable diagnoses Paid bonuses to providers who followed these suggestions Added diagnoses without lab tests or confirmation The same patients suddenly had many more lucrative diagnoses after joining UnitedHealth's Medicare Advantage plans versus before. When confronted, rather than addressing the specific allegations about billing practices, UnitedHealth called the WSJs reporting "outrageous and false" and claimed it was part of a "campaign against Medicare Advantage." The company seemingly built entire systems in a deliberate, systematic effort to maximize government payments rather than isolated incidents or honest mistakes.

impish9208 2y ago

Earlier: https://news.ycombinator.com/item?id=43127111 https://news.ycombinator.com/item?id=43127111