Jessica Mendoza

The biggest Medicare Advantage provider, UnitedHealth, told us that the added payments help cover medical care and lower premiums and provide other benefits for members. It also says that chart reviews reflect diagnoses made by patients' doctors. According to the journal's reporting, some of the diagnoses that insurers added to patient records were demonstrably false.

The biggest Medicare Advantage provider, UnitedHealth, told us that the added payments help cover medical care and lower premiums and provide other benefits for members. It also says that chart reviews reflect diagnoses made by patients' doctors. According to the journal's reporting, some of the diagnoses that insurers added to patient records were demonstrably false.

The biggest Medicare Advantage provider, UnitedHealth, told us that the added payments help cover medical care and lower premiums and provide other benefits for members. It also says that chart reviews reflect diagnoses made by patients' doctors. According to the journal's reporting, some of the diagnoses that insurers added to patient records were demonstrably false.

One condition that they looked into was diabetic cataracts. Cataracts, which is when eyes cloud over, are common in the elderly. So is diabetes. But there's another, rarer condition called diabetic cataracts, which is when high blood sugar levels cause that cloudy vision. And a diagnosis of diabetic cataracts was tied to thousands of dollars in extra payments, whereas regular cataracts weren't.

One condition that they looked into was diabetic cataracts. Cataracts, which is when eyes cloud over, are common in the elderly. So is diabetes. But there's another, rarer condition called diabetic cataracts, which is when high blood sugar levels cause that cloudy vision. And a diagnosis of diabetic cataracts was tied to thousands of dollars in extra payments, whereas regular cataracts weren't.

One condition that they looked into was diabetic cataracts. Cataracts, which is when eyes cloud over, are common in the elderly. So is diabetes. But there's another, rarer condition called diabetic cataracts, which is when high blood sugar levels cause that cloudy vision. And a diagnosis of diabetic cataracts was tied to thousands of dollars in extra payments, whereas regular cataracts weren't.

According to the data seen by the journal team, UnitedHealth Medicare Advantage members were about 15 times as likely to have a diagnosis of diabetic cataracts compared to the average patient in traditional Medicare. It was this unusual condition that Kristen, the nurse practitioner with House Calls, says she was encouraged to put down on patient charts.

According to the data seen by the journal team, UnitedHealth Medicare Advantage members were about 15 times as likely to have a diagnosis of diabetic cataracts compared to the average patient in traditional Medicare. It was this unusual condition that Kristen, the nurse practitioner with House Calls, says she was encouraged to put down on patient charts.

According to the data seen by the journal team, UnitedHealth Medicare Advantage members were about 15 times as likely to have a diagnosis of diabetic cataracts compared to the average patient in traditional Medicare. It was this unusual condition that Kristen, the nurse practitioner with House Calls, says she was encouraged to put down on patient charts.

Eye doctors interviewed by the journal team said it was unlikely that such a large share of UnitedHealth patients could have this relatively rare disease. Chris also saw patterns in the data that implied some of the patients who were getting diagnosed with diabetic cataracts didn't have the condition at all.

Eye doctors interviewed by the journal team said it was unlikely that such a large share of UnitedHealth patients could have this relatively rare disease. Chris also saw patterns in the data that implied some of the patients who were getting diagnosed with diabetic cataracts didn't have the condition at all.

Eye doctors interviewed by the journal team said it was unlikely that such a large share of UnitedHealth patients could have this relatively rare disease. Chris also saw patterns in the data that implied some of the patients who were getting diagnosed with diabetic cataracts didn't have the condition at all.

For instance, thousands of patients who received the diagnosis had no record of ever being treated for diabetes, while other patients had already had their cataracts treated.

For instance, thousands of patients who received the diagnosis had no record of ever being treated for diabetes, while other patients had already had their cataracts treated.

For instance, thousands of patients who received the diagnosis had no record of ever being treated for diabetes, while other patients had already had their cataracts treated.

UnitedHealth told us they asked their clinicians to use their medical judgment in diagnosing. The company also said it complies with guidance from the Department of Health and Human Services. Now remember, the way Medicare Advantage works is that insurers get paid more by the government for certain diagnoses.

UnitedHealth told us they asked their clinicians to use their medical judgment in diagnosing. The company also said it complies with guidance from the Department of Health and Human Services. Now remember, the way Medicare Advantage works is that insurers get paid more by the government for certain diagnoses.

UnitedHealth told us they asked their clinicians to use their medical judgment in diagnosing. The company also said it complies with guidance from the Department of Health and Human Services. Now remember, the way Medicare Advantage works is that insurers get paid more by the government for certain diagnoses.

Because diabetic cataracts are a costly condition, they come with a big payment, one that added up over time. During the three-year period that Chris looked at, the government paid insurers more than $700 million just for recording diabetic cataracts, even if no doctor provided any treatment. And Medicare Advantage ensures diagnosed all sorts of diseases that were never treated.

Because diabetic cataracts are a costly condition, they come with a big payment, one that added up over time. During the three-year period that Chris looked at, the government paid insurers more than $700 million just for recording diabetic cataracts, even if no doctor provided any treatment. And Medicare Advantage ensures diagnosed all sorts of diseases that were never treated.