{"id":9234,"date":"2025-12-19T23:02:39","date_gmt":"2025-12-19T23:02:39","guid":{"rendered":"https:\/\/mailitics.com\/index.php\/2025\/12\/19\/unitedhealth-group-audits-medicare-advantage-upcoding-optum-rx-discounts\/"},"modified":"2025-12-19T23:02:39","modified_gmt":"2025-12-19T23:02:39","slug":"unitedhealth-group-audits-medicare-advantage-upcoding-optum-rx-discounts","status":"publish","type":"post","link":"https:\/\/mailitics.com\/index.php\/2025\/12\/19\/unitedhealth-group-audits-medicare-advantage-upcoding-optum-rx-discounts\/","title":{"rendered":"STAT+: UnitedHealth proclaims audits show it has \u2018robust\u2019 procedures, in contrast to findings of independent reviews"},"content":{"rendered":"<p>    STAT+: UnitedHealth proclaims audits show it has \u2018robust\u2019 procedures, in contrast to findings of independent reviews<br \/>\n \t<BR><br \/>\n<BR><\/BR><br \/>\n    <!-- no image --><br \/>\n \t<BR><br \/>\n<BR><\/BR><\/p>\n<div>\n<p>UnitedHealth Group said Friday that the consultants it hired to audit its operations, including its practice of applying lucrative diagnosis codes to older adults\u2019 records, found they\u2019re not only \u201crobust,\u201d but \u201cindustry leading.\u201d\u00a0<\/p>\n<p>While the reports give a veneer of transparency, government audits and independent analyses provide far less rosy views of UnitedHealth\u2019s operations \u2014 and contradict some of the consultants\u2019 latest findings. The consultants also make clear they are not attorneys and therefore cannot determine whether UnitedHealth\u2019s policies are compliant with federal and state regulations.<\/p>\n<p>UnitedHealth CEO Stephen Hemsley <a href=\"https:\/\/www.statnews.com\/2025\/06\/02\/unitedhealth-announces-comprehensive-review-of-coding-practices-under-scrutiny-medicare-advantage\/\">promised in June<\/a> to share the audit findings once they were complete. Since taking over in May, Hemsley has pledged a new era of transparency and introspection at the embattled health care conglomerate, whose market value has plummeted by more than $160 billion this year amid <a href=\"https:\/\/www.statnews.com\/2025\/10\/28\/unitedhealth-group-strategy-shift-doctor-network\/\">deteriorating finances<\/a> and <a href=\"https:\/\/www.statnews.com\/2025\/07\/24\/unitedhealth-confirms-doj-medicare-criminal-civil-probes\/\">ongoing government investigations<\/a>.\u00a0<\/p>\n<p><a href=\"https:\/\/www.statnews.com\/2025\/12\/19\/unitedhealth-group-audits-medicare-advantage-upcoding-optum-rx-discounts\/?utm_campaign=rss\">Continue to STAT+ to read the full story\u2026<\/a><\/p>\n<\/div>\n<p> \t<BR><br \/>\n <BR><\/BR><br \/>\n    Tara Bannow and Bob Herman<br \/>\n \t<BR><br \/>\n<BR><\/BR><br \/>\n<a href=\"https:\/\/www.statnews.com\/2025\/12\/19\/unitedhealth-group-audits-medicare-advantage-upcoding-optum-rx-discounts\/?utm_campaign=rss\">Go to statnews<\/a><br \/>\n \t<BR><br \/>\n <BR><\/BR><\/p>\n","protected":false},"excerpt":{"rendered":"<p>STAT+: UnitedHealth proclaims audits show it has \u2018robust\u2019 procedures, in contrast to findings of independent reviews UnitedHealth Group said Friday that the consultants it hired to audit its operations, including its practice of applying lucrative diagnosis codes to older adults\u2019 records, found they\u2019re not only \u201crobust,\u201d but \u201cindustry leading.\u201d\u00a0 While the reports give a veneer [&hellip;]<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[58,2288,2213,2266,2346,2152],"tags":[2150],"class_list":["post-9234","post","type-post","status-publish","format-standard","hentry","category-business","category-health-insurance","category-insurance","category-medicare-advantage","category-pbms","category-stat","tag-statnews"],"_links":{"self":[{"href":"https:\/\/mailitics.com\/index.php\/wp-json\/wp\/v2\/posts\/9234"}],"collection":[{"href":"https:\/\/mailitics.com\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/mailitics.com\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/mailitics.com\/index.php\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/mailitics.com\/index.php\/wp-json\/wp\/v2\/comments?post=9234"}],"version-history":[{"count":0,"href":"https:\/\/mailitics.com\/index.php\/wp-json\/wp\/v2\/posts\/9234\/revisions"}],"wp:attachment":[{"href":"https:\/\/mailitics.com\/index.php\/wp-json\/wp\/v2\/media?parent=9234"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/mailitics.com\/index.php\/wp-json\/wp\/v2\/categories?post=9234"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/mailitics.com\/index.php\/wp-json\/wp\/v2\/tags?post=9234"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}