Here are five recent controversies involving UnitedHealthcare, the insurance arm of UnitedHealth Group, as reported by Becker’s:
1. In a complaint filed Aug. 8 in Arizona, UnitedHealthcare alleged that Radiology Partners and its Arizona affiliate have been gaming the No Surprises Act’s independent dispute resolution process and “funneling millions into the pockets of its private equity owners.” UnitedHealthcare accuses the radiology practice of “abusing” the IDR process by routing in-network claims through Sonoran Radiology to make them appear out-of-network, then initiating the IDR process for tens of thousands of claims.
2. UnitedHealthcare issued a policy update on July 1 that will cut reimbursements for certified registered nurse anesthetists by 15%. Effective Oct. 1, a 15% reduction in reimbursement will be applied to claims for anesthesia services rendered by CRNAs practicing independently. For claims billed under the QZ modifier — those rendered by CRNAs — the CRNA will now receive 85% of the allowable.
3. In a decision issued June 30, Minnesota District Court Judge Mark Ireland ruled against UnitedHealthcare in a lawsuit challenging a Minnesota law barring for-profit insurers from the state’s Medicaid program.
4. Luigi Mangione pleaded not guilty April 25 on federal murder charges in the killing of UnitedHealthcare CEO Brian Thompson. The day prior, federal prosecutors filed their official notice of intent to pursue the death penalty, writing that Mr. Mangione “elected to murder Thompson under these circumstances to amplify an ideological message, maximize the visibility and impact of the victim’s murder, and to provoke broad-based resistance to the victim’s industry.”
5. UnitedHealthcare is suing Broadcom, alleging that the tech giant is looking to impose “exorbitant price increases” on software used by the insurer. The heavily redacted lawsuit, filed in the U.S. District Court for Minnesota on April 2, claims that Broadcom is breaching its contract regarding its “CA software” that UnitedHealthcare has been using since 2006 for claims processing and data management. UnitedHealth claims that switching to an alternative software could take years.
