Jessica Mendoza

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.

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.

Like peripheral artery disease. It's a serious condition where blood vessels get narrower, and in some cases, it can lead to amputations. A House Calls training manual reviewed by the investigations team advised nurse practitioners like Kristen to diagnose peripheral artery disease based on results from a device called the Quantiflow.

Like peripheral artery disease. It's a serious condition where blood vessels get narrower, and in some cases, it can lead to amputations. A House Calls training manual reviewed by the investigations team advised nurse practitioners like Kristen to diagnose peripheral artery disease based on results from a device called the Quantiflow.

Like peripheral artery disease. It's a serious condition where blood vessels get narrower, and in some cases, it can lead to amputations. A House Calls training manual reviewed by the investigations team advised nurse practitioners like Kristen to diagnose peripheral artery disease based on results from a device called the Quantiflow.

If the quanta flow showed decreased blood flow, Kristen was supposed to conclude that the patient had peripheral artery disease. But she says she was uncomfortable making such a definitive diagnosis just based on the device, especially since elderly people often have decreased blood flow.

If the quanta flow showed decreased blood flow, Kristen was supposed to conclude that the patient had peripheral artery disease. But she says she was uncomfortable making such a definitive diagnosis just based on the device, especially since elderly people often have decreased blood flow.

If the quanta flow showed decreased blood flow, Kristen was supposed to conclude that the patient had peripheral artery disease. But she says she was uncomfortable making such a definitive diagnosis just based on the device, especially since elderly people often have decreased blood flow.