UnitedHealth Faces Medicare Billing Investigation
The Justice Department is investigating UnitedHealth Group Inc.'s Medicare billing practices, according to an anonymous source. The news has sent the company's stock into a tailspin.
Civil Fraud Allegations
The Wall Street Journal reports that the investigation centers on whether UnitedHealth's patient diagnoses inflate payments from the Medicare Advantage program. UnitedHealth shares plummeted 7.2% in New York trading. Humana Inc., another major Medicare player, saw a 5.7% decline.
UnitedHealth Denies Wrongdoing
UnitedHealth vehemently denies the accusations. "We are unaware of the 'launch' of any 'new' activity," the company stated. "Any suggestion that our practices are fraudulent is outrageous and false."
Antitrust Probe Continues
The Justice Department is also conducting an antitrust investigation into UnitedHealth's practices, initiated under the Biden administration. This inquiry arose from concerns about UnitedHealth's acquisitions of healthcare providers and data companies. The ultimate decision on this investigation will rest with Trump's antitrust chief, Gail Slater.
Medicare Advantage Under Scrutiny
The Medicare billing allegations may or may not be connected to the antitrust investigation. Medicare Advantage, a private version of Medicare, has come under government scrutiny for its costs. A congressional advisory group has called for a "major overhaul" of the program's payment system.
Insurers' Payment Structure
Insurers receive higher payments for patients with more severe illnesses. The Biden administration has attempted to curb Medicare Advantage payments amid accusations of wasteful spending.
Recent UnitedHealth Controversies
UnitedHealth has faced intense scrutiny in recent months. The head of its insurance division was killed in December, sparking public outrage over insurance denials. The company's shares also fell earlier this month after a billionaire investor alleged profit overstatement. UnitedHealth has responded to the allegations and reported concerns to the SEC.