UnitedHealth Group is facing another government investigation, this one reportedly centered on possible criminal Medicare fraud. Since at least last summer, the Justice Department has been investigating the health insurance company for fraud related to its Medicare Advantage business, reports the Wall Street Journal. Medicare Advantage insurers receive extra payment for covering especially sick patients, meaning there's an incentive to document patients' diagnoses. Previous reporting by the Journal revealed "questionable diagnoses by UnitedHealth added billions to taxpayers' costs," the outlet notes.
Earlier reports described a DOJ civil fraud investigation related to UnitedHealth's Medicare billing practices. In a statement, UnitedHealth says it wasn't informed of the "supposed criminal investigation reported" and stands "by the integrity of our Medicare Advantage program," per Reuters. It previously disputed the Journal's reporting as "inaccurate and biased," saying Medicare Advantage "provides better health outcomes and more affordable healthcare for millions of seniors" than traditional Medicare. But the criminal probe based in New York presents another headache for a company that has seen its stock fall almost 50% in the last month.
The stock fell 8% in after-hours trade following Wednesday's report. That was after it tumbled to its lowest closing price since October 2020 on Tuesday after UnitedHealth backed away from its full-year financial outlook in the face of rising medical costs and announced CEO Andrew Witty would step down "for personal reasons," per MarketWatch. On top of the civil and criminal investigations, the company is also facing government probes into potential antitrust violations, which have contributed to what the Journal calls "a deep deficit of trust among shareholders, regulators and customers." (More UnitedHealth Group stories.)
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