FOR IMMEDIATE RELEASE
June 10, 2025
MEDIA CONTACT
Alexis Posel, [email protected]
New Report: UnitedHealth Group Whistleblowers Witness Delays and Denials to Healthcare for Vulnerable Nursing Home Patients
After Reviewing Whistleblower Aid Disclosures, Senate and House Members Demand Answers from UHC on Prioritizing Profits over Patients
WASHINGTON, D.C., June 10, 2025 – Less than a month after UnitedHealth Group (UHG) CEO Andrew Witty stepped down, two whistleblowers represented by Whistleblower Aid have produced significant evidence which shows that Optum, a subsidiary of UnitedHealthcare (UHC), may be defrauding Medicare through dangerous and deceptive practices. According to our clients, UHC has employed a “playbook” that encourages the delay – or outright denial – of critical hospital care to vulnerable nursing home patients.
Whistleblower Aid submitted a comprehensive disclosure from the two whistleblowers to the Securities and Exchange Commission, the Federal Trade Commission, the Washington State Office of the Attorney General, and Congress demanding an investigation. In response, lawmakers from both parties — including U.S. Senators Ron Wyden (D-OR), Josh Hawley (R-MO), and Richard Blumenthal (D-CT), and U.S. Representatives Alexandria Ocasio-Cortez (D-NY), Lloyd Doggett (D-TX), and Buddy Carter (R-GA) — have publicly raised concerns about UnitedHealth’s deceptive practices. Sen. Wyden, who also serves as the ranking member on the Senate Finance Committee, announced that his office will be launching a full investigation into our clients claims, while Reps. Ocasio-Cortez and Doggett are calling on the Department of Justice to investigate UnitedHealth for jeopardizing the health and safety of its patients.
“Scores of elderly patients may never have received the care that they needed, all because UnitedHealthcare skimped on care to cut costs,” one of the whistleblowers, a nurse practitioner formerly employed by UHC, Dr. Maxwell Ollivant, said. “UnitedHealthcare is compelling medical professionals to comply with its financially-driven playbook at the expense of patient safety in a way that pressures providers to violate their ethical obligations. I’d like to see them held accountable for putting profits over patients.”
In their disclosure, two UHC nurse practitioners expose what they describe as the intimidation and bullying of medical providers into denying their patients access to critical care in favor of reducing costs and maximizing profit. They claim that these practices not only punish providers, but puts patient health and safety at unconscionable risk.
The whistleblowers describe UHC’s cost-cutting measures as indefensible in cases where the company encourages nurses to avoid even the most necessary hospitalizations for emergencies to the detriment of vulnerable patients. Because off-site care and hospitalizations cost the health insurer more money than on-site nursing facility care, our clients claim that UHC designed its “playbook”, its training materials, its rewards system, and a high-pressure company culture to treat off-site care as failures on the part of the provider. This culture, they say, delaying critical care and refusing hospitalizations while rewarding providers who avoid such critical care – all at the cost of patient well-being
Notably, Whistleblower Aid clients witnessed the widely-reported “up-coding” scheme which requires managers and staff to exaggerate patient conditions in order to claim more substantial capitated payments from Medicare Advantage.
Our clients’ disclosures reveal that UHC materials mandate caregivers pressure elderly patients into signing “Do Not Resuscitate” (DNR) orders by misleading them into thinking their conditions are worse than they are – including imminent death. And UHC then relies on these DNR orders denying patients any critical care which minimizes costs incurred by UHC.
In one case our client describes a UHC phone-operator, someone who was off-site and never in contact with the patient, misdiagnosed a man experiencing a stroke and in obvious need of medical attention. The hospital was five minutes away, yet, following UHC’s mandatory ”playbook”, the patient was not admitted to the hospital for over an hour – resulting in permanent neurological damage.
When Whistleblower Aid’s clients did hospitalize a patient in order to save their life, UHC allegedly docked their compensation, and then conducted a grueling, manager-led, retrospective review with an eye to blaming the caregiver for the patient’s change in condition, further traumatizing caregivers into complying with the UHC/Optum playbook.
Despite UnitedHealthcare denying any wrongdoing and suing The Guardian last week, Whistleblower Aid stands by the credibility of our clients and the documentary evidence they produced – and the journalistic integrity of the investigative reporting that brought these concerns to light.
“This is exactly why whistleblowers matter. The greed described here shocks the conscience. I can’t imagine the unnecessary trauma these patients and their families endured – nor the unanswered questions they live with about their loved ones who paid the price for UnitedHealthcare’s greed. We support the ongoing investigations into the claims that UnitedHealthcare is maximizing their profits by trying to force medical providers to delay or deny life-saving care,” Whistleblower Aid CEO, Libby Liu, said.
