U.S. Senator Chuck Grassley requested detailed information on UnitedHealth's (UNH.N) Medicare billing practices, in a letter to CEO Andrew Witty on Monday, amid reports suggesting the insurer may have leveraged billing rules to its advantage.
Shares of the company fell 1.7% to $453.90 in afternoon trading after the Wall Street Journal first reported the news.
Over the last several months, The WSJ has run a series of stories detailing how UnitedHealth profited from using Medicare billing rules to its favor.
Grassley, who heads the Senate Judiciary Committee, demanded the health insurer provide all records relating to the company's compliance program, training manuals and guidance documents to better understand its billing practices.
The letter cited findings from the Journal's articles and said "the apparent fraud, waste, and abuse at issue is simply unacceptable and harms not only Medicare beneficiaries, but also the American taxpayer".
We welcome the opportunity to share the facts with Senator Grassley, especially given the ongoing misinformation campaign by the WSJ, UnitedHealth said in a statement.
The company is expected to provide details before March 10 on its steps to review all diagnoses submitted to the Centers for Medicare & Medicaid Services for Medicare Advantage enrollees, as well as identify if they are obscure, irrelevant or inaccurate, according to the letter.
Nearly half of the 65 million people covered by Medicare, the U.S. program for people aged 65 and older or with disabilities, are enrolled in Medicare Advantage plans run by private insurers.
Insurers are paid a set rate for each patient, but can be paid more for patients with multiple health conditions.
UnitedHealth, with various businesses including a large pharmacy benefit manager, faces margin pressure from rising medical costs in its insurance business.
