The Justice Department has launched an antitrust investigation into UnitedHealth, owner of the biggest U.S. health insurer, a leading manager of drug benefits and a sprawling network of doctor groups. The investigators have in recent weeks been interviewing healthcare-industry representatives in sectors where UnitedHealth competes, including doctor groups, according to […]
U.S. Opens UnitedHealth Antitrust Probe More »
After being sold to Optum, a subsidiary of the health care colossus UnitedHealth Group, naviHealth denied coverage for at least two elderly patients against their doctors’ advice, forcing them to accumulate tens of thousands of dollars in out-of-pocket expenses before they died, according to reporting from STAT News. Employees alleged
Building a Giant: Mapping UnitedHealth’s consumption of our health care system More »
Over the last decade, however, Minnesota has lost more independent pharmacies than any other state. The demise of independent pharmacies in Minnesota and many other places is being hastened by another group of businesses — the PBMs.
Minnesota is losing independent pharmacies, victims of scale, efficiency More »
UnitedHealth Group limits the ability of its workers to deviate from the AI projections, according to the lawsuit. Citing the news article, the complaint says employees who don’t follow the model are disciplined and terminated, without regard to whether patients needed more care.
Lawsuit against UnitedHealth Group of using faulty AI to deny Medicare patient claims More »
The nation’s largest health insurance company pressured its medical staff to cut off payments for seriously ill patients in lockstep with a computer algorithm’s calculations, denying rehabilitation care for older and disabled Americans as profits soared, a STAT investigation has found. UnitedHealth Group has repeatedly said its algorithm, which predicts
UnitedHealth pushed employees to follow an algorithm to cut off Medicare patients’ rehab care More »
The document from Allina Health arrived in February, stating the 61-year-old Woodbury resident owed the hospital a staggering sum — $155,493. It made no sense, Christensen said. He had coverage through his employer from a reputable health insurer. And the need for the care was undeniable; Christensen was hospitalized for
The care was crucial. He had insurance. His hospital bill? A whopping $155,493. More »
In theory, pharmacy benefit managers like to recommend generic drugs and keep prices lower than brand-name pharmaceuticals. But it doesn’t always work out that way when the same company owns a PBM and the retail pharmacy — it can be in the company’s interest to keep prices higher.
Generic drugs get a markup at CVS, Cigna, UnitedHealth report says More »
Today, United is the fifth-largest public company in the U.S., bigger than JPMorgan Chase. Its insurance products serve 50 million members, more than the population of Spain, and its $186 billion health services division, Optum, has 103 million patients, more than Vietnam’s population. Earnings came to $28.4 billion last year,
Health Care’s Intertwined Colossus More »
“Large insurance companies continue to do all they can to deny, delay or reduce payments for emergency care,” Dr. Christopher Kang, president of the American College of Emergency Physicians, said in a statement. “Immediate action to strengthen enforcement of the prudent layperson standard and other existing laws can help hold
U.S. Department of Labor sues UnitedHealth Group over thousands of denied claims More »
Underpayment from Caremark has caused many non-CVS pharmacies to close, creating “pharmacy deserts” in many urban neighborhoods and rural areas. CVS Health has been able to achieve and abuse its power through a series of mergers and acquisitions. Had our existing antitrust laws — such as the Clayton Act —
CVS hellth – Corporate consolidation is ruining pharmacies and hurting patients More »
