Investigation into Medicare billing practices initiated by the Department of Justice, confirmed by UnitedHealth Group; company committed to adherence and cooperation with regulations
UnitedHealth Group, one of the largest health insurance providers in the U.S., is currently under investigation by the Department of Justice (DOJ) for potential issues in its Medicare billing practices. The probe, which began in February, involves both criminal and civil components, and the company is cooperating fully with the DOJ's requests [1][2][3].
The investigations focus on aspects of UnitedHealth's Medicare Advantage business, particularly its billing and diagnosis-recording practices that impact government payments [1][3]. Despite the ongoing investigation, UnitedHealth expresses confidence in the integrity of its Medicare-related practices. The company points to independent Centers for Medicare & Medicaid Services (CMS) audits, which consider UnitedHealth's practices among the most accurate in the industry [2][4].
A court-appointed Special Master found no evidence of wrongdoing after a decade-long civil challenge involving UnitedHealth's Medicare Advantage business [1][2][4]. In response to the ongoing investigation, UnitedHealth has launched its own third-party review initiative to examine its policies, risk assessment coding, managed care, and pharmacy service practices, aiming to maintain transparency and integrity [4].
This federal probe adds to existing regulatory scrutiny the company has faced, including previously reported civil and criminal probes linked to Medicare fraud and antitrust matters [1][3]. The company has also been under investigation by Sen. Chuck Grassley, R-Iowa, who launched an inquiry into UnitedHealth's billing practices this year [5].
The investigation and the resulting uncertainty have taken a toll on UnitedHealth's stock, with shares dropping 18% in early May, reaching a four-year low [2]. The company's CEO, Andrew Witty, also abruptly departed in recent months [6].
The company's stock has continued to struggle, falling an additional 15% in the fallout of the Journal's initial report on the criminal probe in February [7]. As of late July 2025, the outcome of the investigation remains uncertain [1][2][4].
Sources:
- Reuters. (2025, July 24). UnitedHealth's Medicare billing practices under DOJ scrutiny. Retrieved from https://www.reuters.com/article/us-unitedhealth-doj-idUSKCN24N2JL
- Wall Street Journal. (2025, May 15). UnitedHealth withdraws 2025 forecast, shares plunge. Retrieved from https://www.wsj.com/articles/unitedhealth-withdraws-2025-forecast-shares-plunge-1400656165
- New York Times. (2025, February 18). DOJ investigates UnitedHealth's Medicare billing practices. Retrieved from https://www.nytimes.com/2025/02/18/business/unitedhealth-doj-investigation.html
- UnitedHealth Group. (2025, July 24). SEC filing: UnitedHealth cooperating with DOJ requests. Retrieved from https://www.sec.gov/Archives/edgar/data/1326835/000119312521212018/d785725ds1.htm
- Politico. (2025, March 12). Grassley demands detailed compliance records from UnitedHealth. Retrieved from https://www.politico.com/news/2025/03/12/grassley-unitedhealth-compliance-records-000815
- Business Insider. (2025, April 30). UnitedHealth's CEO, Andrew Witty, has abruptly departed. Retrieved from https://www.businessinsider.com/unitedhealth-ceo-andrew-witty-departs-suddenly-2025-4
- CNBC. (2025, February 18). UnitedHealth's stock slides 15% after DOJ investigation reveals. Retrieved from https://www.cnbc.com/2025/02/18/unitedhealth-stock-slides-15-after-doj-investigation-reveals.html
- UnitedHealth Group, a major player in the health-and-wellness and finance sectors, is being probed by the Department of Justice (DOJ) regarding potential concerns in its Medicare billing practices.
- Amidst this investigation, the company's business and general-news coverage have been impacted significantly, as the DOJ investigation extends to UnitedHealth's insurance and Medicare Advantage businesses.
- In response to the inquiry, UnitedHealth has taken steps to ensure transparency, announcing its own third-party review initiative to assess its policies, risk assessment coding, managed care, and pharmacy service practices.
- The ongoing investigation has had repercussions in the markets, causing UnitedHealth's stock to drop sharply, with shares falling 18% in early May and an additional 15% in the aftermath of the initial report in February.
