UNH News & Events

UnitedHealth Group subsidiaries OptumRx and Emisar Pharma Services and the Federal Trade Commission have reached an agreement that would settle allegations that the companies engaged in "anticompetitive and unfair rebating practices that have artificially inflated the list price of insulin drugs." "Counsel and Respondents OptumRx, Inc., OptumRx Holdings, LLC, and Emisar Pharma Services LLC (collectively, the "Optum Respondents"), having moved jointly to withdraw the matter from adjudication with respect to the Optum Respondents for the purpose of considering a proposed consent agreement; and Complaint Counsel and the Optum Respondents, having submitted a proposed consent agreement containing a proposed decision and order, executed by the Optum Respondents and by Complaint Counsel and approved by the Directors of the Bureaus of Competition and Consumer Protection that, if accepted by the Commission, would resolve the claims against the Optum Respondents in their entirety," the FTC order reads. "IT IS ORDERED, pursuant to Rule 3.25(c) of the Commission's Rules of Practice, 16 C.F.R. Section 3.25(c), that -- with respect to the Optum Respondents -- this matter be, and hereby is, withdrawn from adjudication and that all proceedings against the Optum Respondents before the Administrative Law Judge be, and hereby are, stayed, pending a determination by the Commission with respect to the proposed Consent Agreement, pursuant to Rule 3.25(f) of the Commission's Rules of Practice, 16 C.F.R. Section 3.25(f); and IT IS FURTHER ORDERED, pursuant to Rule 3.25(b) of the Commission's Rules of Practice, 16 C.F.R. Section 3.25(b), that the proposed Consent Agreement shall not be placed on the public record unless and until it is accepted by the Commission."

According to new reports from the inspector general's office at the Department of Health and Human Services focusing on major health insurers, UnitedHealth (UNH), Humana (HUM), and CVS Health (CVS), whose plans cover the bulk of individuals enrolled in Medicare Advantage, denied about 13% of patients requests to go to a skilled nursing facility to continue recovery after surgery or serious illness, Reed Ableson of The New York Times reports. The investigators also raised concerns over whether outside contractors determining if the patient should get more specialized care were being adequately supervised. Overall, one in five patients appealed the denials and nearly all were reversed. The high percentage of overturned ruling suggest some people's care was inappropriately delayed while others may have not obtained the care they needed.