Department of Justice investigating UnitedHealth Group for Antitrust Violations

February 21, 2025 – UnitedHealth Group, a leading U.S. healthcare conglomerate, is currently under investigation by the Department of Justice (DOJ) for its Medicare billing practices. The probe centers on allegations that the company recorded questionable diagnoses to secure higher payments from Medicare Advantage plans. Following reports of the investigation, UnitedHealth’s stock experienced a significant decline, dropping approximately 9% and erasing about $30 billion from its market capitalization.

The Wall Street Journal revealed that UnitedHealth received billions in Medicare payments based on potentially dubious diagnoses. In response, the company has denied any fraudulent activity, asserting that its practices aim to enhance patient care and facilitate early disease detection.

This DOJ investigation adds to UnitedHealth’s existing legal challenges, including an antitrust probe concerning its attempted $3.3 billion acquisition of home healthcare company Amedisys. The scrutiny reflects a broader governmental focus on addressing fraud and abuse within the healthcare sector, with bipartisan support in Washington for such initiatives.

Industry analysts highlight that Medicare Advantage programs have resulted in $83 billion more in spending in 2024 compared to traditional Medicare, partly due to practices like “upcoding,” where insurers report all medical conditions to maximize payments. This has raised concerns about potential overbilling and the ethical implications of such practices.

The outcome of the DOJ’s investigation could have significant ramifications for UnitedHealth and the broader healthcare industry, potentially leading to increased regulatory oversight and reforms aimed at curbing excessive billing practices.