I'm also glad to speak with @angeladavismpr.bsky.social about the three major crimes UnitedHealthcare has been sued for by three AGS in three states since May 2026 including collusion, price-fixing, rigging an algorithm, malfeasance, defrauding Medicaid, negligence, upcoding and more.
October 2, 2026 at 1:13 PM
I'm also glad to speak with @angeladavismpr.bsky.social about the three major crimes UnitedHealthcare has been sued for by three AGS in three states since May 2026 including collusion, price-fixing, rigging an algorithm, malfeasance, defrauding Medicaid, negligence, upcoding and more.
So corruption and fraud seem to be rampant regarding Medicare: it’s called upcoding. Hey guys! Here is your fraud! Consequences? Naaaah- don’t count on it.
www.yahoo.com/news/politic...
www.yahoo.com/news/politic...
Federal watchdog accuses Humana, UnitedHealthcare Medicare Advantage plans of upcoding
Newly released HHS OIG audits of HumanaChoice and UnitedHealthcare of Wisconsin found both plans frequently exaggerated the health needs of their members, generating almost $180 million in overpayment...
www.yahoo.com
October 1, 2026 at 1:32 AM
So corruption and fraud seem to be rampant regarding Medicare: it’s called upcoding. Hey guys! Here is your fraud! Consequences? Naaaah- don’t count on it.
www.yahoo.com/news/politic...
www.yahoo.com/news/politic...
#UnitedHealthcare estimated it had overpaid about $100 million on #TeamHealth claims since 2016. #Settlement terms are confidential. #Alleged #Upcoding #Litigation buff.ly/y4IePsw
UnitedHealthcare, TeamHealth settle $100M alleged upcoding case
UnitedHealthcare and TeamHealth have settled a lawsuit in which the insurer accused the physician staffing company of upcoding emergency department claims.
buff.ly
September 30, 2026 at 4:02 PM
#UnitedHealthcare estimated it had overpaid about $100 million on #TeamHealth claims since 2016. #Settlement terms are confidential. #Alleged #Upcoding #Litigation buff.ly/y4IePsw
The Corporate Medicine sharks, vipers and vultures are cannibalising each other.
UnitedHealthcare and TeamHealth have settled a lawsuit in which the commercial health insurance investment bank accused the physician staffing company of upcoding ED claims.
www.beckerspayer.com/legal/united...
UnitedHealthcare and TeamHealth have settled a lawsuit in which the commercial health insurance investment bank accused the physician staffing company of upcoding ED claims.
www.beckerspayer.com/legal/united...
UnitedHealthcare, TeamHealth settle $100M alleged upcoding case - Becker's Payer Issues | Payer News
UnitedHealthcare and TeamHealth have settled a lawsuit in which the insurer accused the physician staffing company of upcoding emergency department claims. The lawsuit was voluntarily dismissed with ...
www.beckerspayer.com
September 30, 2026 at 3:27 AM
The Corporate Medicine sharks, vipers and vultures are cannibalising each other.
UnitedHealthcare and TeamHealth have settled a lawsuit in which the commercial health insurance investment bank accused the physician staffing company of upcoding ED claims.
www.beckerspayer.com/legal/united...
UnitedHealthcare and TeamHealth have settled a lawsuit in which the commercial health insurance investment bank accused the physician staffing company of upcoding ED claims.
www.beckerspayer.com/legal/united...
AI was supposed to cut healthcare waste. Instead, it's driving a $942M upcoding arms race. Hospitals use algorithms to maximize billing, insurers use AI to deny claims, and costs are projected to spike 9% by 2027. The tech is automating inflation.
AI Billing Tools Spark Healthcare Spending Fight
The promise of automated medical coding is colliding with the reality of runaway healthcare costs.
yesilscience.com
September 28, 2026 at 9:01 PM
AI was supposed to cut healthcare waste. Instead, it's driving a $942M upcoding arms race. Hospitals use algorithms to maximize billing, insurers use AI to deny claims, and costs are projected to spike 9% by 2027. The tech is automating inflation.
Rick Scott was the CEO of Columbia/HCA. The company defrauded Medicare by deliberately inflating patient diagnoses to maximize billing, a practice known as "upcoding", submitted falsified corporate cost reports and paid illegal financial kickbacks to doctors in exchange for patient referrals.
September 27, 2026 at 10:40 PM
Rick Scott was the CEO of Columbia/HCA. The company defrauded Medicare by deliberately inflating patient diagnoses to maximize billing, a practice known as "upcoding", submitted falsified corporate cost reports and paid illegal financial kickbacks to doctors in exchange for patient referrals.
UnitedHealthcare / Humana face federal & state civil lawsuits, investigations regarding fraud, upcoding & improper denials in Medicare Advantage plans
State attorneys general have targeted major insurers for manipulating member health statuses to siphon millions from public programs like Medicaid.
State attorneys general have targeted major insurers for manipulating member health statuses to siphon millions from public programs like Medicaid.
Assistant AG for Fraud Colin McDonald: "Apparently 35% of people have never even used their Obamacare account for any health services. That is a statistical impossibility and it's because these are not real people seeking real care. These are fraudsters."
September 27, 2026 at 5:39 AM
UnitedHealthcare / Humana face federal & state civil lawsuits, investigations regarding fraud, upcoding & improper denials in Medicare Advantage plans
State attorneys general have targeted major insurers for manipulating member health statuses to siphon millions from public programs like Medicaid.
State attorneys general have targeted major insurers for manipulating member health statuses to siphon millions from public programs like Medicaid.
Hospitals handing their insurance claims to AI triggered a $942M spending surge over two years. The algorithms are aggressively upcoding complex conditions with zero change in actual care. Medical billing bots just optimize the extraction of capital from insurers.
Hospitals Using AI for Medical Billing Drove an Extra $942M in Costs, Insurers Claim
Hospitals using AI for medical coding drove an extra $942M in healthcare spending over two years.
zubiqo.com
September 27, 2026 at 1:07 AM
Hospitals handing their insurance claims to AI triggered a $942M spending surge over two years. The algorithms are aggressively upcoding complex conditions with zero change in actual care. Medical billing bots just optimize the extraction of capital from insurers.
*FTR: Upcoding is unethical and illegal.
I've had doctors ask me to do it and I said NO because I'm not going to jail for a doctor's bank balance to go up. I've had doctors who mark codes that the records don't support. Billers shouldn't be doing that shit.
I've had doctors ask me to do it and I said NO because I'm not going to jail for a doctor's bank balance to go up. I've had doctors who mark codes that the records don't support. Billers shouldn't be doing that shit.
September 25, 2026 at 4:44 PM
*FTR: Upcoding is unethical and illegal.
I've had doctors ask me to do it and I said NO because I'm not going to jail for a doctor's bank balance to go up. I've had doctors who mark codes that the records don't support. Billers shouldn't be doing that shit.
I've had doctors ask me to do it and I said NO because I'm not going to jail for a doctor's bank balance to go up. I've had doctors who mark codes that the records don't support. Billers shouldn't be doing that shit.
Private insurers have always benefited from favorable selection relative to traditional Medicare and because of inadequate risk adjustment (driven in large part by upcoding) that leads to overpayments. MedPAC has been estimating the size of the overpayments for many years, as have outside analysts.
GOP aims to change Medicare adviser’s math so it’s more favorable to health insurers
Lawmakers advance bill to change how MedPAC studies spending
www.statnews.com/2026/09/16/m...
Lawmakers advance bill to change how MedPAC studies spending
www.statnews.com/2026/09/16/m...
GOP aims to change Medicare adviser’s math so it's more favorable to health insurers
The GOP bill directs MedPAC to study the topic of overpayments to Medicare Advantage plans in a manner that’s more favorable to insurers.
www.statnews.com
September 25, 2026 at 2:53 AM
Private insurers have always benefited from favorable selection relative to traditional Medicare and because of inadequate risk adjustment (driven in large part by upcoding) that leads to overpayments. MedPAC has been estimating the size of the overpayments for many years, as have outside analysts.
Blue Cross Says Hospital AI Added Nearly $1 Billion in Costs
Blue Cross Says Hospital AI Added Nearly $1 Billion in Costs
Its new report says AI tools are turning up more billable diagnoses without patients getting sicker. Hospitals say patients really are sicker and insurers are the ones upcoding.
dlvr.it
September 24, 2026 at 11:31 PM
Blue Cross Says Hospital AI Added Nearly $1 Billion in Costs
Blue Cross Says Hospital AI Added Nearly $1 Billion in Costs
Blue Cross Says Hospital AI Added Nearly $1 Billion in Costs
Its new report says AI tools are turning up more billable diagnoses without patients getting sicker. Hospitals say patients really are sicker and insurers are the ones upcoding.
dlvr.it
September 24, 2026 at 11:31 PM
Blue Cross Says Hospital AI Added Nearly $1 Billion in Costs
Might it be that AI was more ethical, that the robots avoided upcoding?
September 24, 2026 at 6:56 PM
Might it be that AI was more ethical, that the robots avoided upcoding?
Sunday night television meets public health data. 📺✨
ICYMI @lastweektonight.com featured research from #BrownSPH that revealed UnitedHealth Group "upcoding" leads to over $12 BILLION each year in extra payments.
Here's the episode ⤵️
ICYMI @lastweektonight.com featured research from #BrownSPH that revealed UnitedHealth Group "upcoding" leads to over $12 BILLION each year in extra payments.
Here's the episode ⤵️
UnitedHealthcare & UnitedHealth Group: Last Week Tonight with John Oliver (HBO)
YouTube video by LastWeekTonight
youtu.be
September 24, 2026 at 5:46 PM
Sunday night television meets public health data. 📺✨
ICYMI @lastweektonight.com featured research from #BrownSPH that revealed UnitedHealth Group "upcoding" leads to over $12 BILLION each year in extra payments.
Here's the episode ⤵️
ICYMI @lastweektonight.com featured research from #BrownSPH that revealed UnitedHealth Group "upcoding" leads to over $12 BILLION each year in extra payments.
Here's the episode ⤵️
AI adjudication tools like UnitedHealth’s Predict have been accused of often erroneously denying needed care, hoping that patients/providers don’t take the time to appeal. A recent lawsuit alleges that the 0.2% of patients who do appeal win about 9 out of 10, reversing the AI-powered tool’s denial.
September 23, 2026 at 8:41 PM
AI adjudication tools like UnitedHealth’s Predict have been accused of often erroneously denying needed care, hoping that patients/providers don’t take the time to appeal. A recent lawsuit alleges that the 0.2% of patients who do appeal win about 9 out of 10, reversing the AI-powered tool’s denial.
There’s also the AI arms race in upcoding vs payment integrity. It’s getting worse, not better, and it baffles me because that’s precisely how you get M4A.
September 23, 2026 at 4:14 PM
There’s also the AI arms race in upcoding vs payment integrity. It’s getting worse, not better, and it baffles me because that’s precisely how you get M4A.
These people are liars! Let's talk fraud. There's 650 billion a year in healthcare fraud and it's not being committed by patients! Phantom billing, double billing, upcoding, unbundling, billing for unnecessary services are just a few forms of fraud. Stop this and it would pay for healthcare for all.
September 23, 2026 at 4:12 PM
These people are liars! Let's talk fraud. There's 650 billion a year in healthcare fraud and it's not being committed by patients! Phantom billing, double billing, upcoding, unbundling, billing for unnecessary services are just a few forms of fraud. Stop this and it would pay for healthcare for all.
Liz, I watch John Oliver too. Fact:Me & 100 constituents reported this yrs ago, proving fraud of $100M+ in tax $.
MA is Ground Zero for this. Christopher P. if CCA is a prime ex of AI + VC capturing healthcare for profit. Promising “rapid growth & scale”? Cancer does that too. Do something.
MA is Ground Zero for this. Christopher P. if CCA is a prime ex of AI + VC capturing healthcare for profit. Promising “rapid growth & scale”? Cancer does that too. Do something.
September 22, 2026 at 10:22 PM
Liz, I watch John Oliver too. Fact:Me & 100 constituents reported this yrs ago, proving fraud of $100M+ in tax $.
MA is Ground Zero for this. Christopher P. if CCA is a prime ex of AI + VC capturing healthcare for profit. Promising “rapid growth & scale”? Cancer does that too. Do something.
MA is Ground Zero for this. Christopher P. if CCA is a prime ex of AI + VC capturing healthcare for profit. Promising “rapid growth & scale”? Cancer does that too. Do something.
“We easily lost over a million dollars, because of that hack. I'm just a pediatric brain surgeon, right? So what do I know?” -Pediatric Brain Surgeon. Liz, me and 100 constituents called your offices years ago about upcoding, out right fraud, AI, VI & abuse! You ignored us. Why now? Reelection?
September 22, 2026 at 10:16 PM
“We easily lost over a million dollars, because of that hack. I'm just a pediatric brain surgeon, right? So what do I know?” -Pediatric Brain Surgeon. Liz, me and 100 constituents called your offices years ago about upcoding, out right fraud, AI, VI & abuse! You ignored us. Why now? Reelection?
Of course the fraud originates with the sick healthcare recipient — never the huge healthcare conglomerate upcoding and overcharging. Booting the neediest off will let them charge even more while having to provide less service. MAGA donors rejoice!
September 22, 2026 at 5:50 PM
Of course the fraud originates with the sick healthcare recipient — never the huge healthcare conglomerate upcoding and overcharging. Booting the neediest off will let them charge even more while having to provide less service. MAGA donors rejoice!