Major insurers accused of defrauding Medicare

May 23, 2017

The complexities of billing the Medicare program may have provided cover for some major health insurers in an effort to defraud the federal government. According to a report from The New York Times, the companies may have exaggerated patient diagnoses to inflate Medicare payments by billions of dollars. Buffalo Congressman Brian Higgins decried the practice, calling it a "blatant violation of the public trust."

UnitedHealth Group and other insurers face a Justice Department investigation for allegedly defrauding the Medicare program.

In responding to The New York Timesa spokesperson for UnitedHealth Group said the Justice Department "fundamentally misunderstands" how the  federal health care program works. He also maintained that the company and its employees followed appropriate rules in their billing procedures. 

The statement did not satisfy Higgins who took to the floor of the House of Representatives to encourage Justice Department officials to investigate the matter "aggressively and thoroughly."

"If these allegations are true, these actions would represent among the most egregious schemes of fraud perpetrated against the American people."

Higgins also painted the subject with a partisan brush, claiming the Republican-sponsored American Heath Care Act "gave a $78 million tax cut to the executives of the very companies that are under investigation, including a $15.5 million tax cut to United (Health Group) and their chief executive officer."