The DOJ is investigating whether UnitedHealth made its clinician employees record questionable diagnoses that make Medicare Advantage patients appear sicker than they are. This practice, known as “upcoding”, triggered extra federal payments. Additionally, former UnitedHealth employees have reported the company pressed nurse practitioners to persuade Medicare Advantage members to change their “code status” to DNR – do not resuscitate – rendering them ineligible for certain life saving treatments that might lead to costly hospital stays. In early May 2025, the Justice Department sued Aetna, UnitedHealth and Humana for allegedly paying brokers hundreds of millions of dollars to steer older Americans to their Medicare Advantage plans – and, to steer clear of potential enrollees with disabilities. [MSNBC, May 2025]
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