{"id":396605,"date":"2026-01-08T18:09:07","date_gmt":"2026-01-08T18:09:07","guid":{"rendered":"https:\/\/www.newsbeep.com\/ca\/396605\/"},"modified":"2026-01-08T18:09:07","modified_gmt":"2026-01-08T18:09:07","slug":"senators-claim-unitedhealth-is-withholding-internal-documents-from-inquiry-us-healthcare","status":"publish","type":"post","link":"https:\/\/www.newsbeep.com\/ca\/396605\/","title":{"rendered":"Senators claim UnitedHealth is withholding internal documents from inquiry | US healthcare"},"content":{"rendered":"

UnitedHealth has refused to hand over key internal records to lawmakers investigating the company\u2019s efforts to reduce hospital transfers<\/a> for nursing home residents, according to a 7 January letter sent to the company by the US senators Ron Wyden and Elizabeth Warren.<\/p>\n

The veteran lawmakers, both members of the powerful Senate finance committee, launched their inquiry last summer following a Guardian investigation<\/a> into bonuses that UnitedHealth pays to nursing homes that reduce hospital transfers for their residents. Those are hospitalizations the insurance giant would otherwise have to pay for.<\/p>\n

UnitedHealth did not directly respond to questions from the Guardian about the senators\u2019 assertion that the company had failed to turn over internal documents. But it said in a statement that it will \u201ccontinue to engage\u201d with the senators and that its nursing home care program \u201cimproves outcomes\u201d and \u201creduces unnecessary hospitalizations\u201d.<\/p>\n

The new letter from the senators says that in the five months since they formally requested<\/a> a tranche of documents about the initiative, UnitedHealth has \u201cdeclined to produce\u201d any internal records on its hospitalization policies or bonus payments and only provided \u201cbrief and unsubstantial answers\u201d in response to their questions.<\/p>\n

\u201cBecause you have failed to respond adequately to our inquiry \u2013 and in light of additional recent reporting \u2013 we are renewing our inquiry with heightened alarm,\u201d Wyden and Warren wrote in the letter.<\/p>\n

That \u201cadditional recent reporting\u201d referred to a December story<\/a> by the Guardian reporting on allegations of three wrongful deaths involving the company\u2019s nursing home care program, which allows staff from UnitedHealth\u2019s medical arm, Optum, to care for residents insured by its insurance arm, UnitedHealthcare.<\/p>\n

In a statement to the Guardian, UnitedHealth said it categorically rejects any assertion that it engages in practices that \u201cendanger patient safety or violate ethical standards\u201d.<\/p>\n

\u201cWe stand firmly behind our program, which has provided decades of compliant, specialized care and support for seniors in nursing homes,\u201d a UnitedHealth spokesperson said.<\/p>\n

The letter provides new details on Wyden and Warren\u2019s ongoing investigation into UnitedHealth.<\/p>\n

On 29 July the senators\u2019 offices held a briefing with UnitedHealth in which the company maintained that nursing homes in its program are not required to have conversations with the company\u2019s direct care division before sending residents to the hospital, according to the letter.<\/p>\n

Wyden and Warren wrote that this claim \u201cis at odds\u201d with a company document, which was provided to the Senate finance committee by a whistleblower. The document showed that UnitedHealth pushed nursing homes to \u201cimmediately\u201d call its direct care division even if they were sending out an insured UnitedHealth member \u201curgently\u201d, according to the senators\u2019 letter.<\/p>\n

After the briefing, most of the Senate staff\u2019s questions \u201cwere unresolved\u201d, the letter says. UnitedHealth was \u201cunable to justify\u201d, for example, its use of hospital admission rates as a metric for determining bonus payments to nursing homes, Wyden and Warren wrote. Such metrics do not distinguish between necessary and unnecessary hospitalizations, as the senators have previously noted<\/a>.<\/p>\n

In the 7 January letter, the senators recirculated their previous document demands and gave UnitedHealth until 28 January to respond.<\/p>\n

\u201cIf you fail to respond in full, we will pursue answers to this critical inquiry by other policy means,\u201d they continued.<\/p>\n

Under Medicare Advantage, insurers such as UnitedHealth receive fixed payments from the federal government that cover the medical expenses of long-term nursing home residents. The fewer hospitalizations they have to pay for, the more in federal funds they have left over for potential profits.<\/p>\n

UnitedHealth and its medical care division, Optum, are facing lawsuits relating to its nursing home program, as the Guardian previously reported.<\/p>\n

In Ohio, the family of a retiree named Mary Grant is suing UnitedHealth, claiming that the 70-year-old died after her nursing home and UnitedHealth\u2019s Optum division failed to send her to the hospital, though she had suffered a traumatic head injury and began vomiting.<\/p>\n

The Optum nurse practitioner overseeing the senior\u2019s care was acting not \u201cas an independent and objective medical professional\u201d but instead as \u201can insurance adjuster\u201d so that the healthcare giant could \u201cpreemptively deny Mary Grant necessary medical care\u201d, the family alleged in their court complaint.<\/p>\n

In Georgia, the family of a woman named Cindy Deal is alleging that staff from her nursing home and Optum failed to hospitalize the 58-year-old for hours, though she had started foaming at the mouth and appeared to be having a seizure, resulting in her death.<\/p>\n

The company \u201cacted to block the provision of life-saving care to Ms Deal pursuant to corporate policies intended to increase profits at the expense of its insured\u201d, an amended complaint from last November alleges.<\/p>\n

UnitedHealth did not directly respond to questions about these cases.<\/p>\n

UnitedHealth has previously declined to directly respond to questions about the cases, citing patient privacy rules and the pending nature of the litigation, but said generally that many of the claims were unsubstantiated or based on incomplete or embellished information.<\/p>\n

The company has previously<\/a> denied<\/a> claims from Grant and Deal\u2019s families in court.<\/p>\n

\u201cUnited works with the nursing facility, primary care physicians, and specialists to deliver appropriate care for members in the most appropriate setting,\u201d the company previously told the Guardian, noting that a non-profit called the National Committee for Quality Assurance recently awarded its care model a 98.75% score.<\/p>\n

In June, UnitedHealth sued the Guardian, alleging defamation for a story about bonuses the company paid to nursing homes that helped it to reduce hospital transfers for their residents. The suit was the latest in a series of aggressive tactics aimed at silencing critics, the New York Times reported<\/a>.<\/p>\n

In the wake of the suit, the Guardian stood by its story, and continued to report on the company\u2019s nursing home practices.<\/p>\n","protected":false},"excerpt":{"rendered":"UnitedHealth has refused to hand over key internal records to lawmakers investigating the company\u2019s efforts to reduce hospital…\n","protected":false},"author":2,"featured_media":396606,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[34],"tags":[49,48,84,392],"class_list":{"0":"post-396605","1":"post","2":"type-post","3":"status-publish","4":"format-standard","5":"has-post-thumbnail","7":"category-healthcare","8":"tag-ca","9":"tag-canada","10":"tag-health","11":"tag-healthcare"},"_links":{"self":[{"href":"https:\/\/www.newsbeep.com\/ca\/wp-json\/wp\/v2\/posts\/396605","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.newsbeep.com\/ca\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.newsbeep.com\/ca\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/ca\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/ca\/wp-json\/wp\/v2\/comments?post=396605"}],"version-history":[{"count":0,"href":"https:\/\/www.newsbeep.com\/ca\/wp-json\/wp\/v2\/posts\/396605\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/ca\/wp-json\/wp\/v2\/media\/396606"}],"wp:attachment":[{"href":"https:\/\/www.newsbeep.com\/ca\/wp-json\/wp\/v2\/media?parent=396605"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.newsbeep.com\/ca\/wp-json\/wp\/v2\/categories?post=396605"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.newsbeep.com\/ca\/wp-json\/wp\/v2\/tags?post=396605"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}