The federal government, through the Medicare program, purportedly pays bonuses to medical insurance companies that provide high-quality coverage to Medicare and Medicare Advantage customers. The companies that perform the best with the fewest customer complaints are given these financial incentives. However, though United Healthcare has been highly rated and well rewarded for its high rankings, a federal judge recently unsealed a whistleblower suit that alleges serious misconduct within the company. United Healthcare has customers throughout the nation, including many senior clients in Michigan who may be interested in the details of these allegations.
According to two employees who filed the suit, executives within the company allowed the existence of two separate books that recorded customer complaints. Along with these allegations, there have been complaints lodged against some sales agents who purportedly engaged in offering unethical incentives to customers to sign up for a specified time period. Another sales associate was accused of forging signatures on customer contracts.
While one employee was dismissed for paying the incentives, company executives denied that any wrongdoing occurred. The federal lawsuit focused primarily on the allegations that United Healthcare actively engaged in covering up the numbers of complaints that were received. Along with concealing the actual figures, two of the whistleblowers allege that the company deliberately slowed the process of investigating complaints and ruled that the majority of them were unsubstantiated.
In spite of the serious allegations put forth by the whistleblower lawsuit, a determination was made that the Justice Department would not take on the Wisconsin case, which means that bonuses will not be subject to recovery. In many instances, employees who report unethical, illegal or other wrongdoing on the part of their employers may face retaliation in the form of reassignment, harassment or termination. Michigan workers who have taken steps to expose poor behaviors or policies and are concerned about this retaliation may choose to seek the input and counsel of an experienced employment law professional who can guide them through the process while protecting their rights.
Source: publicintegrity.org, “Whistleblowers: United Healthcare hid complaints about Medicare Advantage“, Fred Schulte, July 28, 2017