UnitedHealth Group
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Consumer / Employer, Legal, Payers
Labor Department Sues UnitedHealth Group Over ‘Thousands’ of Claims Denials
The Labor Department recently sued UnitedHealth Group subsidiary UMR, alleging that it wrongfully denied claims for emergency room services and urinary drug screenings since 2015. UMR did not determine the medical necessity of the claims, denying them “based solely on diagnosis codes and not applying a prudent layperson standard,” according to the complaint.
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Healthcare Moves: A Monthly Summary of Hires and Layoffs
Here is a selection of recent executive hires, departures and layoffs occurring across the healthcare industry.
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Payer’s Place: Dawn Maroney
Dawn Maroney, President, Markets of Alignment Health and CEO of Alignment Health Plan, to discuss how they are using technology to provide better service and care to consumers.
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UnitedHealth, American Nurses Foundation Launch Program for Nurse Burnout
The program aims to improve work environments for nurses and remove the stigma associated with asking for mental health care. The curriculum will focus on ways to identify and reduce stress before it escalates. While it will help all nurses, the program is especially geared toward nurses of color and those under the age of 35.
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What’s Behind the M&A Spree in the Hospice Industry
While the top-level view of the growth in the hospice industry at 20-plus percent is impressive, it’s worth looking at a few prominent examples to gain further insight into this accelerating trend.
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Walmart, UnitedHealth Group form 10-year value-based care partnership
Through the collaboration, UnitedHealth Group’s Optum will use its analytics and support tools to help Walmart Health clinicians deliver value-based care to Medicare Advantage beneficiaries. The partnership is starting at 15 locations in Florida and Georgia with the potential to grow in the future.
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Department of Justice sues to block UnitedHealth from acquiring Change Healthcare
The Department of Justice filed the lawsuit in the U.S. District Court for the District of Columbia to stop the deal just ahead of it being finalized on February 27.
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UnitedHealth, Change meet requirements for DOJ investigation, agree not to merge before February
The companies have certified substantial compliance with a request for additional information from the Department of Justice, which opened an investigation of the merger in March. They struck an agreement with the agency not to merge until February of 2022, unless it drops its investigation before then.
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Consumer / Employer, Legal, SYN
Pharmacists join chorus calling for DOJ to stop Optum-Change Healthcare merger
Independent and community pharmacies seek to prevent UHG and Change merging into a “corporate monster” that will stifle competition.
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Lawsuit: Like a “boa constrictor,” UnitedHealthcare squeezed anesthesia group out of competition
U.S. Anesthesia Partners has filed lawsuits against UnitedHealthcare in Colorado and Texas, accusing the payer of forcing it out of network and intentionally interfering with its relationships with providers in those states. But, according to UnitedHealthcare, the lawsuits are an attempt to get the insurer to meet the anesthesia group’s high rate demands.
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Applying Remote Patient Monitoring to Surgery Prep and Recovery, Oncology and Women’s Health
Join us to learn about the latest trends in remote monitoring and how to extend its benefits beyond chronic conditions to more patients – all while using fewer staff resources.
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Hospitals to DOJ: UnitedHealth’s purchase of Change Healthcare will curtail competition
The American Hospital Association is urging the Justice Department to thoroughly review UnitedHealth’s intended acquisition of Change Healthcare. The transaction would reduce competition in the health IT arena and result in higher prices and lower quality of care, the hospital group says.
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UnitedHealth subsidiary indicted for no-poach agreements with competitors
A federal grand jury indicted Surgical Care Affiliates, a network of surgical centers and hospitals owned by UnitedHealthcare, for agreeing with competitors not to poach top-level talent.
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UnitedHealth Group’s Optum, Change Healthcare to combine in $13.5B deal
Optum, a subsidiary of insurance giant UnitedHealth Group, agreed to buy healthcare technology company Change Healthcare for $13.5 billion in cash. The acquisition will add data analytics, research and revenue cycle management offerings to Optum’s service roster.
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Big profits put insurers on awkward footing
During the height of the Covid-19 pandemic, all of the seven largest commercial insurers saw their profits rise, with some seeing their profits double. Will they have to pay some of it back?
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Gilead got a boost from a newly approved PrEP drug. Now, a major insurer is dropping coverage
UnitedHealthcare sent a notice to plan members stating that it would no longer cover Descovy to prevent HIV, while Truvada – after it goes generic next month – will be covered for free. Gilead reported that Descovy for PrEP had offset a second-quarter fall in product sales.
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UnitedHealth Group sees profits double due to Covid-19
UnitedHealth Group saw its earnings nearly double to $6.6 billion during the second quarter, as fewer patients sought out appointments or non-essential procedures due to the pandemic.
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Payer’s Place: Dr. Anil Singh
Dr. Anil Singh shares his insights into the strategies employed by the organization to identify the most effective digital solutions for their members.
Promoted
Discover the Next-Gen Platform for Integrated Collaborative Care
Beyond EHRs and digital front doors, reducing the gaps in patient care journeys.
