Senators seek UnitedHealth records on push to curb nursing home hospitalizations | US healthcare

US deputies, the country’s largest health -hall, Unitedhealth Group, internal documents to reduce hospital transfers for nursing home residents and want to explain the bonuses to the maintenance homes that help him do so.

On August 6 letterDemocratic senators Ron Wyden and Elizabeth Warren asked Stephen Hemsley, CEO of Unitedhealth, to deliver a company registrations about a partnership program on a partnership program on the country all over the country and thus delivering the coverage costs for conglomeration. The document request letter follows a guardian investigation into the initiative.

“Simply put, these claims are UHG [UnitedHealth Group] UHG seems to prioritize the profitability of the nursing home residents registered to the SNPs at the expense of health and security, Wyden Wyden and Warren referred to a kind of Unitedhealth plan for long-term nursing home residents.

Unitedhealth argues that the program is designed to prevent “unnecessary” hospitalization. There is a company He was strongly rejected Guardian’s allegations based on Guardian’s thousands of secret corporate and patient records, public records and court files, more than 20 present and interviews with the former Unitedhealth and Nursing Home employees and two notification of the Congress in May Information Flying Help.

Un We are standing behind the integrity of our I-SNP program, which is constantly receiving high satisfaction ratings, Söz “Claims are due to an article that incorrectly represents a program that provides high -quality care and providing an advanced coordination between personalized clinical care and carers.

Wyden’s and Warren’s offices received a briefing about the program from Unitedhealth on July 29th. According to the August 6 letter, both deputies sitting at the Strong Senate Finance Committee said that they “worried” about the various aspects of the Unitedhealth Nursing Home initiative.

Senators, for example, pointed out that as Unitedhealth’s previously reported, the inhabitants of Unitedhealth paid some care houses bonuses according to the hospital transfer rate. However, this bonus metric is not prevented against inevitable hospitalization, but rather sets a limit to hospitalization for any reason, making it a weak measure of care quality. ”

The company said that bonus payments to care homes before, helping patients to prevent unnecessary hospitalization that can be costly and dangerous and improved the health results of their partnerships with care homes.

Wyden and Warren are also looking for information about how the company’s plans talk about the medicare advantage, a customized alternative to traditional Medicare, how it markets to the nursing home residents, and how employees talk about the advanced care directives that can affect their ability to reach hospital care. Senators also demand information about whether federal regulators have imposed some Unitedhealth Medicare advantage plans for long -term nursing home residents in the last five years.

Health Holder faced lawsuits that the employees claimed that they were trying to record the residents of the nursing home to Medicare Advantage Plans and that they were at risk or damaged by helping to delay or prevent critical hospital transfers. Under the advantage of medicare, federal government pays fixed amounts to insurance companies to meet the care of the elderly, this is a model. Critics Inappropriate tactics can encourage coverage expenses.

Unitedhealth previously claimed that Guardian’s report was “clearly wrong and misleading ve and said that his suggestion that his employees prevented hospital transfers was“ correctly wrong ”. Unitedhealth sued Guardian for slander Shortly after Outlet reported that he had published a follow -up investigation in the nursing home.

The document request letter from Wyden and Warren comes only a few months after the deputies of both parties are concerned about the activities of Unitedhealth’s nursing home.

In June, two congresses were Alexandria Ocasio-Cortez from Democrat-New York and Lloyd Doggett-GÖNDENDEN from Texas a letter He wants the Ministry of Justice to “comprehensively review new revelations from the complaints of investigation and information flying, which suggests that Unitedhealth may have been engaged in illegal activities”.

Similarly, Missouri Republican Josh Hawley at the Senate Investigations sub -committee promised to provide justice for patients, policy holders and informants who are damaged by insurance companies ”.

In his letters on Thursday, he asked Warren and United United to provide a complete, written response to his investigations until September 8th.

In his statement, Unitedhealth will continue to educate his staff and share information about the I-SNP model and the proven benefit for the elderly ”.