Overview
- Democratic Senators Ron Wyden and Elizabeth Warren have launched a Senate investigation into UnitedHealth Group’s Institutional Special Needs Plans for nursing home residents.
- The lawmakers have asked UHG to submit internal documents, care protocols and training materials by September 8 to determine whether its bonus models influenced treatment decisions.
- The probe centers on incentives tied to keeping hospital admissions below set thresholds without distinguishing medically necessary transfers, and on reports of pressure to sign do-not-resuscitate or do-not-intubate orders.
- Reporting by The Guardian based on confidential records and whistleblower accounts alleges that delayed or denied hospital care under UHG’s programs caused serious patient harm.
- UnitedHealth disputes the allegations, maintains its I-SNP plans reflect high-quality nursing home care and says it is cooperating with existing Department of Justice subpoenas into its Medicare Advantage practices.