The shocking murder of UnitedHealthcare CEO Brian Thompson has police scrambling to find a motive. Thompson was gunned down Dec. 4 on a midtown Manhattan sidewalk on his way to his company’s investor day meeting.
From the start, police called it a “targeted killing,” with several witnesses saying the gunman staked out the area well before Thompson passed by.
Clues found at the scene have led to speculation about a motive. Shell casings found at the murder scene were inscribed with the words “deny” and “delay,” leading some to suggest the CEO of the nation’s largest health insurance provider could have been the target of a revenge killing.
To be clear, police have refused to speculate on a motive for the killing and so far, have focused their attention on identifying and apprehending the gunman, whose act was caught on surveillance video. But a look at UnitedHealthcare’s business practices will no doubt fuel speculation.
Among the highest denials of coverage
On Oct. 17, Sen. Richard Blumenthal, chair of the Senate Permanent Committee on Investigations, released a subcommittee report that examined the business practices of health benefit providers.
The subcommittee found that between 2019 and 2022, UnitedHealthcare, Humana, and CVS each denied prior authorization requests for post-acute care “at far higher rates than they did for other types of care, resulting in diminished access to post-acute care for Medicare Advantage beneficiaries.”
In 2022, both UnitedHealthcare and CVS denied prior authorization requests for post-acute care at rates that were approximately three times higher than the companies’ overall denial rates for prior authorization requests. In that same year, Humana’s prior authorization denial rate for post-acute care was over 16 times higher than its overall rate of denial.
Prior authorization
Health benefit providers use prior authorization to cover certain procedures as a way to limit fraud and unnecessary treatments. In recent years, some critics have charged the practice has been used to limit payouts and increase profits. Blumenthal is one of those critics.
“Despite alarm and criticism in recent years about abuses and excesses, insurers have continued to deny care to vulnerable seniors, simply to make more money,” Bluementhal said in an October statement that accompanied the release of the report. “Our subcommittee even found evidence of insurers expanding this practice in recent years.”
In November 2023, the families of two former UnitedHealthcare patients sued the company, claiming that UnitedHealthcare employed artificial intelligence to review claims, resulting in a significant increase in denials of procedures recommended by doctors.
The suit claims the AI algorithm, known as nH Predict, had a 90% error rate but that the company continued to use it.
Police, meanwhile, expressed confidence that they will be able to identify the gunman. There are numerous images of the shooter from different surveillance cameras, including two images where his face is not fully covered.