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Tuesday, Jul 5 2016

Full Issue

UnitedHealthcare Claims Dialysis Chain Engaged In Fraudulent, Illegal Billing Scheme

The lawsuit, filed by UnitedHealthcare, alleges the for-profit dialysis chain American Renal Associates Holdings Inc. illegally pushed poor people in Florida and Ohio to leave inexpensive government programs and sign up for private plans sold by UnitedHealthcare so the dialysis chain could get higher reimbursements from the insurer.

Private health insurers can pay more than $4,000 for each dialysis treatment. Government health plans like Medicaid pay around $200. That gaping price difference was the motivation for a scheme, orchestrated by a for-profit dialysis chain, that illegally pushed poor people in Florida and Ohio out of inexpensive government programs and into expensive private plans sold by UnitedHealthcare, according to a lawsuit the giant insurer filed in federal court on Friday. UnitedHealthcare says the arrangement needlessly exposed the patients to medical bills. (Abelson and Thomas, 7/1)

UnitedHealth Group Inc. sued kidney-care chain American Renal Associates Holdings Inc., accusing it of fraud as health-industry fights escalate over who is allowed to help consumers pay for Affordable Care Act coverage. The lawsuit by the biggest U.S. health insurer, filed Friday in U.S. District Court in Florida鈥檚 Southern District, said American Renal Associates engaged in a 鈥渇raudulent and illegal scheme鈥 to get larger payments from the insurer by convincing patients to sign up for UnitedHealth plans and connecting them with a charity that helped pay their premiums. (Wilde Mathews, 7/1)

This is part of the Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.
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