Discussion about this post

User's avatar
Stephen Hannah's avatar

I don't trust anything this DOJ does. Yes, no doubt there are ongoing shenanigans by UHC and the like... but I don't trust this DOJ not to use this situation as a way that could eventually limit, restrict, or outright deny REAL serious, undiagnosed medical issues and their necessary interventions.

Expand full comment
Patrick J. Pine's avatar

As the manager of a union benefit plan - self insured - we do have a program of intensive bill review as well as normal claims processing reviews - we do see some "upcoding", too - perhaps not to the degree that CMS does for Medicare or states do for Medicaid. We see significant "unbundling" by many hospitals/health systems - where they bill for services that should be part of the bundled charge. We suggest that the DOJ should look at that, too.

Expand full comment
6 more comments...

No posts