A newly proposed bill could prevent insurance companies from owning health care providers that are reimbursed through Medicare Part B or Part C.
Sens. Elizabeth Warren (D-Mass.) and Jeff Merkley (D-Ore.) introduced the Patients Over Profits Act in the Senate; whereas Reps. Pat Ryan (D-N.Y.) and Pramila Jayapal (D-Wa.) brought forth the House version. If either bill passes, insurers would be unable to legally purchase those provider companies and would have to divest any that they already own.
While if enacted the bill would apply to all insurers, lawmakers pointed to the insurance mammoth UnitedHealth Group (NYSE: UNH), which in the past several years acquired the large-scale home health and hospice providers Amedisys and LHC Group, among other provider businesses.
“Breaking up UnitedHealth’s insurance and physician businesses is the first step toward building something better, where every American is able to get the care they deserve at a price they can afford,” Ryan said in a statement.
The UnitedHealth Group subsidiary Optum, in June 2023, inked its agreement to acquire Amedisys in an all-cash transaction of $101 per share, or about $3.3 billion. That deal closed in August following a legal battle with the U.S. Department of Justice that ended in the companies’ favor, with a settlement agreement.
UnitedHealth Group in 2023 also acquired the large home health and hospice provider LHC Group for $5.4 billion.
If enacted, the bill would allow the Federal Trade Commission, state attorneys general, the U.S. Department of Health & Human Services (HHS) Office of the Inspector General or the U.S. Justice Department to file civil lawsuits against insurance companies that do not divest their Parts B or C provider companies.
Other provisions of the proposed bill would prohibit the HHS secretary from contracting with Medicare Advantage plans that also own Part B or Part B businesses.
“Across the country, insurance companies are buying up doctors’ offices, driving up costs and putting insurance company profits over patients,” Warren said in a statement. “Our bill cracks down on greedy insurance companies’ attempts to control doctors and squeeze patients for every cent.”
