Rep. Ryan Unveils Scathing Report on Optum’s Impact in Hudson Valley, Calls for Federal Probe

Hudson Valley Congressman Pat Ryan has released the results of a community inquiry into the operations of Optum-owned medical practices in the Hudson Valley, highlighting widespread complaints about deteriorating care quality, billing errors, and accessibility issues. 

The findings, based on more than 1,800 patient responses, have been submitted to the Department of Justice, the Department of Health and Human Services, and the Federal Trade Commission for further investigation.

The Dutchess County lawmaker said the inquiry uncovered significant concerns, including declining care standards, increased fees, and customer service failures. Several healthcare providers also reported worsened working conditions, contributing to the decline in patient care.

“The volume of responses, the specificity of issues, and the frankly heartbreaking stories involved are unlike anything I’ve seen in my time in Congress,” the Democratic congressman stated. “I’ve heard from disabled children unable to get treatment. Mothers waiting almost a year for a cancer diagnosis. Families sent into debt because of overcharges for treatments never even received. All so the largest health care company in the world can continue to make record breaking profits.”

Among the key findings, 36 percent of respondents reported serious customer service problems, particularly with Optum’s centralized phone system, which prevents direct communication with medical offices. Patients described extraordinary wait times, difficulties in accessing medical records, and missed medication due to communication failures.

Billing errors were another major issue, with 25 percent of respondents reporting double billing and unexplained fees. Many patients described prolonged disputes with Optum over incorrect charges, with some waiting over a year for refunds.

Quality of care has also suffered, according to 41 percent of respondents. Patients reported shorter appointments, difficulty obtaining prescriptions, and long wait times for specialist visits. Nearly half of those surveyed said they had trouble scheduling appointments, and 37 percent noted increased wait times.

Former and current Optum employees echoed these concerns, citing poor working conditions, staff reductions, and an overburdened workforce. Several employees described feeling undervalued and overworked, with some healthcare providers leaving due to burnout.

In late February, The Examiner connected with an Optum spokesperson, after Ryan unveiled his survey. 

“Since these practices chose to join Optum, we have introduced a number of new measures to continue to enhance our services, including dedicated teams responsible for scheduling and supporting medication refills and clinical questions, as well as technology investments to improve our patients’ experiences,” the spokesperson said in an emailed statement. “We, too, have felt the impact of the national health care provider shortage and are continuing to invest in solutions to attract, support and retain our dedicated care providers.”

Since late 2022, The Examiner has been investigating Optum’s impact on local healthcare, with an emphasis on the fallout in northern Westchester. 

Ryan’s office released statements from patients who replied to the survey.

“What Optum has done is put a corporate wall between my children and their physician and therefore their overall health,” a patient named Naomi from Marlboro stated. “After the Optum takeover, their doctor became less attentive and less relaxed in our visits, and seemed to need to push us out the door to see the next patient. Their phone tree method of triaging patients is an absolute disaster. I have waited for hours and hours for a call-back while my kids are sick. I am working towards leaving them, though I’ve discovered that there are very few alternatives in the area and am nervous about finding the right fit for my kids since we’re starting over from scratch.”

Another patient named Kimberly said she tried for more than a year to get an appointment with a specialist and kept getting pushed off, with her appointments repeatedly cancelled.

“Once I finally did get in, it turned out to be cancer,” the Tivoli resident stated. “They made me wait a year to be seen, and it was cancer. I was incredibly lucky that it wasn’t too late. I’ve had to go without essential medication for days, despite calling in my refills, because Optum has messed up my prescriptions. Most recently, I went in for a torn rotator cuff. The doctor, who I could only see by walking in, said he needed to see me again in a week. That was nearly a month ago and I haven’t been able to get back in. I’ve been lucky so far, but someone is going to die if they don’t get these problems under control.” 

Patients also emphasized how they usually love their providers but it’s the corporate structure that presents the problem.

“It is the practices of the company that make the experience nightmarish,” said a Middletown Optum patient who didn’t permit their name to be used. “I’ve had to wait for days following critical tests, making stressful times that much worse. Most recently I couldn’t get my diabetic medication. It took me threatening to go to the news or sue to get the prescription filled, and even then I ended up missing a week of my medication.”

Optum, a subsidiary of UnitedHealth Group, has aggressively acquired medical practices nationwide, including the Hudson Valley’s CareMount Medical and Crystal Run Healthcare. Ryan expressed concerns that UnitedHealth’s dominance in healthcare services, insurance, and pharmaceutical management is leading to reduced competition and higher costs for patients.

In response, Ryan said in a press release today that he has pushed for legislative reforms to increase transparency and accountability in the healthcare industry. 

He said his Stopping Pharma’s Ripoffs Act “would rein in Big Pharma’s current abuse of U.S. patent law, and make it easier to produce less-costly generic drug alternatives.” 

The congressman hasn’t yet noted what new legislative action he might seek in response to the survey results but he did vow to push federal agencies to act on the findings. 

“I’ve already been in touch with Optum to get folks help on an individual basis in the short term, but that’s just a band-aid,” Ryan said. “Today I’m formally submitting every single piece of data to the Department of Justice, the Department of Health and Human Services, and the Federal Trade Commission for further investigation. And I will be pushing around the clock for further action.”