UnitedHealthcare sues national dialysis chain for fraud

UnitedHealthcare is suing a national dialysis company, claining American Renal Associates has been exploiting the insurance provider and its own poorer patients for money collected from dialysis treatment.

According to the New York Times, the company operates more than 200 clinics throughout the country and is partnered with the patient advocacy group the American Kidney Fund.

In the lawsuit filed July 1 in Florida, United alleged that American Renal Associates, using the American Kidney Funds’ influence, has fraudulently convinced patients to switch from their regular health coverage (such as cheap private plans or public plans like Medicaid) to the more expensive UnitedHealthCare, said the Times. The plan would help American Renal Associates make significantly more money—the Times points out that government plans often only reimburse up to $200 per dialysis treatment, while insurance providers like United might reimburse up to $4,000 per treatment.

United argues this scheme to get patients to switch is bad for them and for their customers—United has paid $2 million to American Renal Associates in 2016 so far (and saddled the insurer with more expensive, sicker patients who might otherwise be covered by government insurance), and patients are unwittingly being ushered into a private health plan with premiums they can’t actually afford. Some in the dialysis industry have pointed out the sketchy ethics of such a situation.

The vice president of American Renal Associates denied any wrongdoing in a statement to the Times, saying the company always puts patients first. But critics say the company mostly has its eye on the bottom line. 

Caitlin Wilson,

Senior Writer

As a Senior Writer at TriMed Media Group, Caitlin covers breaking news across several facets of the healthcare industry for all of TriMed's brands.

Around the web

The American College of Cardiology has shared its perspective on new CMS payment policies, highlighting revenue concerns while providing key details for cardiologists and other cardiology professionals. 

As debate simmers over how best to regulate AI, experts continue to offer guidance on where to start, how to proceed and what to emphasize. A new resource models its recommendations on what its authors call the “SETO Loop.”

FDA Commissioner Robert Califf, MD, said the clinical community needs to combat health misinformation at a grassroots level. He warned that patients are immersed in a "sea of misinformation without a compass."

Trimed Popup
Trimed Popup