UnitedHealth, Humana and Cigna Group are accused of falsely diagnosing illnesses in order to reap billions of dollars in additional payments from the Medicare program. Let's take a look at the scandal.
Fifty billion, that's what US insurers received from Medicare for fictitious diseases between 2018 and 2021.
Insurance companies canvassed patients for additional health tests, sometimes luring them with gift vouchers, and then made hundreds of thousands of dubious or erroneous diagnoses to obtain payments from the government's Medicare Advantage insurance program.
Rare pathologies, such as diabetic cataracts, arterial obstructions or even HIV infections, were diagnosed by insurer reps. These diagnoses did not result in any loss of income, but were made in the course of the year.
These diagnoses led to no care or treatment, or were contradicted by the patients' own doctors. In many cases, patients and doctors were not even informed of the illnesses attributed.
The insurers involved - UnitedHealth, Humana, Cigna Group, Freedom Health (Elevance Health) among others - dispute the accusations.
In 2021, diagnoses made by UnitedHealth for illnesses that no doctor treated generated $8.7 billion. For total net income of $17.3 billion.
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