UnitedHealth used aggressive Medicare tactics, Senate committee report says

[BumRushDaShow]

Source: Reuters

January 12, 2026 11:35 AM EST Updated 1 hour ago


Jan 12 (Reuters) - Health insurer UnitedHealth Group (UNH.N) used aggressive risk-adjustment coding tactics to increase U.S. government reimbursement ​for patients enrolled in its Medicare Advantage healthcare plans, a U.S. ‌Senate committee report said on Monday. Shares of the company were down about 1.6% at $338.21 on Monday morning.

Medicare is a U.S. government program for individuals aged 65 and older or those with disabilities. The government reimburses private health plans, called Medicare Advantage, a set ‌amount for each patient but pays more if patients are ​sicker.

The report from Senator Chuck Grassley, who chairs the Senate's judiciary committee, said the company submitted more diagnoses and diagnosis codes than any other Medicare ‍Advantage organization. This resulted in higher government payments tied to the poor health of its patients than any of its peers, the report added.

"After a review of the records, this report provides evidence ⁠that shows UnitedHealth Group has turned risk adjustment into a major profit ‍centered strategy, which was not the original intent of the program," the report stated. The investigation ‌was ‌first reported by The Wall Street Journal earlier in the day.

Read more: https://www.reuters.com/business/healthcare-pharmaceuticals/senate-report-says-unitedhealth-used-aggressive-tactics-boost-medicare-payments-2026-01-12/

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Link to REPORT (PDF) - https://prod-i.a.dj.com/public/resources/documents/grassleyunh0112.pdf

[ret5hd]

1. abolish private health insurance.

start with “part c”.

[ihaveaquestion]

2. I switched to UHC Med Advantage for this year... Not because I wanted to, but...

because it was the only reasonable plan available to me at the time. I suspect the plan will be gone or have greatly reduced in a year or two though. I'll probably have to switch to straight Medicare at some point.

[WSHazel]

3. What to believe?

Grassley may be in the tank for a competitor.

[SidneyR]

4. Medicare (dis-) advantage only works when you don't cost them too much.

Once you do, here come the denials. Regular Medicare won't deny your care.

[BumRushDaShow]

5. "Regular Medicare won't deny your care."

Yet...

Remember who is in charge of that. I'll give you a hint -