(NewsNation) — UnitedHealth Group has been accused of giving nursing homes bonuses for reducing the number of patients sent to hospitals.
An August letter from Democratic Sens. Elizabeth Warren and Ron Wyden demanded the insurance company hand over relevant records by September.
“We are writing in response to alarming reports of UnitedHealth Group padding revenues through cost-cutting programs that imperil the health, safety, and lives of vulnerable seniors and people with disabilities living in nursing homes,” the letter read.
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So far, no files have been released.
“We received the Senators’ letter and will continue to educate their staff and share information on the I-SNP model and its proven benefit for seniors,” a UnitedHealth spokesperson said in a statement to NewsNation. “We stand firmly behind the integrity of our I-SNP program … The U.S. Department of Justice extensively reviewed these allegations and found no evidence of wrongdoing.”
The I-SNP, or institutional special needs plan, is a health care plan that optimizes care for people who require long-term care in a facility, such as a nursing home.
‘I’m just a son’: Family seeks answers on nursing home care
Vincent Cinque, whose mother and grandmother are in nursing homes, said they have been affected by their switch to Optum, one of the insurance policies under scrutiny.
He told “Morning in America” on Monday that his mother was encouraged to change plans with the promise of “more individualized care for a situation that needed more individualized attention.”
“After we switched to UnitedHealthcare’s plan, my mom was moved to a locked dementia unit,” Cinque said. “My mom does not have dementia.”
Cinque said his mother, Teresa, suffered a traumatic brain injury in a near-fatal car crash in 1990 and has been waiting nearly four years for urgent orthopedic care. He’s now working with Disability Rights New York to have her transferred off the dementia floor.
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Cinque also believes his grandmother, Annamare, had a medical issue that was concealed for up to eight months — a “potentially harmful diagnosis” he says he wasn’t told about.
“I can’t really think of any other reason that me as her health care proxy and her power of attorney wouldn’t have been alerted to the situation, other than wanting to keep hospital transfers to a minimum,” he said. “Whatever it was, I don’t think my grandma’s best interest was in mind when these decisions were made.”
Cinque said he hasn’t heard directly from UnitedHealth but is trying to obtain claim records to determine whether the decisions were made by the nursing home or the insurer.
“I’m just a son and a grandson who loves his family and wants them to get the care they need,” he said. “It shouldn’t be halted this long.”
