Unresolved issues at its insurance unit and repeat violations during regulatory audits were some of the findings cited in the first outside reviews commissioned by the managed care giant UnitedHealth (UNH) regarding its business practices, according to Bloomberg News.
The regulatory audits in question looked at how the company manages patient care, including prior authorization, a procedure under which healthcare providers are required to obtain coverage approvals before conducting certain non-emergency medical procedures.
While the reviewers’ findings released on Friday described the company’s business practices as “robust,” there were issues in areas facing regulatory scrutiny. In response, UnitedHealth (UNH) said it’s taking nearly two dozen actions, such as updating and centralizing policies, according to Bloomberg.
The review also looked at how the company’s Optum Rx pharmacy benefits unit deals with discounts and rebates from drugmakers, a major regulatory issue the company is facing over its role in rising drug prices in the U.S.
The reviews performed by FTI Consulting (FCN) and Analysis Group came at a time when the Eden Prairie, Minnesota-based healthcare giant was under intense regulatory scrutiny.
In June, UnitedHealth (UNH) disclosed that it was complying with both civil and criminal requests from the U.S. Department of Justice related to an ongoing probe into its Medicare business.
UNH’s new chief executive, Stephen Hemsley, who retook the company’s leadership from former CEO Andrew Witty earlier this year, pledged to commission the reviews during a shareholder meeting in June.