UnitedHealthcare Fraud, Violations, and Settlements
This is a Live Blog about UnitedHealthcare Fraud and Violations
As a provider, Health Plan, MSO, IPA, every day we’re trying our best to help patients and providers without increasing the cost of healthcare. However, the biggest National Health Insurer continues to raise the cost of healthcare and violate the same rules and regulations that you and we aim to avoid. We aim to begin documenting and updating every possible fraud, waste, abuse, and violation, so you the reader have one article to bookmark and keep up to date on.
Latest 2025 Updates
- February 21, 2025: Medicare Diagnosis Fraud. US Justice Department is opening a Civil Fraud Investigation in regards to illegally using patient diagnoses to increase lump sum monthly payments received through Medicare (source1, source2).
- February 24, 2025: Telemarketing Violation Settlement. $2.5 million settlement was reached for New Yorkers who could receive up to $1,000 per person for violating hte Federal Telephone Consumer Protection Act (source).
UnitedHealth Group Violations Summary
If you’ve never visited Taken from Good Jobs First, you’re missing out on one of the biggest fraud and violation trackers in the world! Let’s take a look at UnitedHealth Group’s violations and get a full picture of the fraud, waste, and abuse that continues in their organization. We thank them for bringing information into the mainstream media like the data seen below:
UnitedHealth Group’s Top 5 Findings of Fraud
| Top 5 Offenses by "Group" | Penalty Total | Number of Records | Avg. for Each Group |
|---|---|---|---|
| consumer-protection-related offenses | $827,406,143 | 333 | $2,484,703 |
| government-contracting-related offenses | $196,539,180 | 8 | $24,567,398 |
| competition-related offenses | $63,125,000 | 3 | $21,041,667 |
| employment-related offenses | $44,958,410 | 22 | $2,043,564 |
| healthcare-related offenses | $4,898,000 | 4 | $1,224,500 |
| $1,132,028,733 | 366 | $3,092,975 |
| Top 5 Primary Offense "Types" | PENALTY TOTAL | NUMBER OF RECORDS | Avg. for Each Group |
|---|---|---|---|
| consumer protection violation | $433,176,667 | 18 | $24,065,370 |
| insurance violation | $393,524,476 | 312 | $1,261,296 |
| False Claims Act and related | $196,539,180 | 8 | $24,567,398 |
| price-fixing or anti-competitive practices | $63,125,000 | 3 | $21,041,667 |
| benefit plan administrator violation | $35,534,249 | 3 | $11,844,750 |
| $1,086,365,323 | 341 | $3,185,822 |
| Company | Offense Type | Year | Agency | Penalty Amount |
|---|---|---|---|---|
| UnitedHealth Group, Inc. | consumer protection violation | 2010 | private lawsuit-federal | $350,000,000 |
| Pacificare Life and Health Insurance Co. | insurance violation | 2014 | CA-INS | $173,603,750 |
| PacifiCare Health Systems | False Claims Act and related | 2002 | DOJ_CIVIL | $87,300,000 |
| LHC Group Inc. | False Claims Act and related | 2011 | DOJ_CIVIL | $65,000,000 |
| UnitedHealth Group Inc. | consumer protection violation | 2009 | NY-AG | $50,000,000 |
Additional UnitedHealth Group Fraud and Articles for Reference
Justice.gov Article on UnitedHealth Group Fraud 2017
DOJ Sues UnitedHealth for $1 Billion
2010 $350,000 Million in Fraud
New York Times: UHG whistleblower, US Government Fraud, OIG
DOJ drops UHG lawsuits and crumbles under pressure
Louisiana AG sues UHG over Medicaid Fraud
UHG Hides Compliants over MA Plans
UHG wins Fraud suing Labs Company… Why didn’t they review their claims first?
The list goes on and one, all you have to do is search “UnitedHealth Group Fraud” and the results are overwhelming. We hope this short article has opened your eyes to fraudulent abuses that UHG has continued to get away with and will continue to perform in the future.
Our History and Credibility in Reporting this Information:
For over 30 years, PCG Software Inc. has been a leader in AI-powered medical coding solutions, helping Health Plans, MSOs, IPAs, TPAs, and Health Systems save millions annually by reducing costs, fraud, waste, abuse, and improving claims and compliance department efficiencies. Our innovative software solutions include Virtual Examiner® for Payers, VEWS™ for Payers and Billing Software integrations, and iVECoder® for clinics.
