Senators Ron Wyden and Elizabeth Warren formally renewed their inquiry into UnitedHealth Group’s nursing‑home care practices, sending a follow‑up letter Jan. 7 to UHG CEO Stephen Hemsley after concluding the company’s earlier responses were insufficient.
The renewed inquiry is rooted in allegations that UnitedHealth’s Optum division has pressured nursing homes to minimize hospital transfers among members covered under Institutional Special Needs Plans (I‑SNPs) — potentially putting cost containment ahead of necessary medical care for vulnerable residents.
The letter begins by reiterating concerns first raised in an August 2025 inquiry, which sought details about internal policies and documentation after reports emerged that UHG’s incentive structures may have encouraged nursing homes to limit hospitalizations below clinically appropriate levels.
According to the senators, UnitedHealth’s earlier responses failed to provide documentation or satisfactory explanations regarding key aspects of its I‑SNP care model. The letter notes that UHG declined to produce documents related to:
- Hospitalization policies and clinical protocols governing when residents are transferred to hospitals.
- Internal bonus programs and quality metrics, including the “admits per thousand” (APK) metric reportedly used to determine incentive payments to nursing homes.
- Optum’s training materials and guidance to staff on hospitalization decisions.
- Advance directive policies, including how Optum staff are trained to conduct end‑of‑life care planning with nursing home residents.
The senators cite recent reporting and whistleblower disclosures alleging that at least three nursing home residents died after Optum employees delayed or discouraged medically necessary hospital transfers.
In the letter, Wyden and Warren give UnitedHealth a January 28 deadline to provide complete responses and documentation. The senators warn that failure to comply will prompt further action “using all tools at the Committee’s disposal.”
In response, UnitedHealth said it would continue to engage with Senators Wyden and Warren, categorically rejecting any suggestion that its practices endanger patient safety or violate ethical standards. The company emphasized that its approach aims to improve outcomes, reduce unnecessary hospitalizations, and support individualized care planning, and that it stands firmly behind its decades-long nursing home program.
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