UnitedHealth Group revealed Thursday it’s going through a Division of Justice investigation over its Medicare billing practices, including to a string of setbacks for a corporation that owns the nation’s largest and strongest personal insurer.
In a securities submitting, the corporate mentioned it has began complying with formal prison and civil requests from the DOJ, and that it reached out to the division after experiences of the probes surfaced. UnitedHealth additionally mentioned it has launched a third-party overview of its enterprise insurance policies and efficiency metrics.
The corporate advised CNBC that it expects to finish that overview in direction of the tip of the third quarter.
Within the submitting, UnitedHealth mentioned it “has full confidence in its practices and is dedicated to working cooperatively with the Division all through this course of.”
UnitedHealth Group shares dropped round 2% on Thursday. The corporate’s executives will seemingly face questions concerning the probe throughout its second-quarter earnings name on July 29.
Jared Holz, Mizuho Securities well being care strategist, mentioned in an e-mail to shoppers on Thursday that the announcement is “not surprising,” however famous that the corporate beforehand denied DOJ investigation claims. He mentioned UnitedHealth’s determination to confess to the probe and cooperate with the division “all sounds logical because it strikes ahead with a brand new CEO.”
The corporate introduced the abrupt departure of former CEO Andrew Witty in Could.
UnitedHealth’s announcement on Thursday comes after the Wall Road Journal reported in Could that the Division of Justice is conducting a prison investigation into the health-care large over potential Medicare fraud. In response on the time, the corporate mentioned it stands “by the integrity of our Medicare Benefit program.”
In July, the Journal additionally reported that the DOJ interviewed a number of medical doctors about UnitedHealth’s practices and whether or not they felt pressured to submit claims for sure situations that bolstered funds from the Medicare Benefit program to the corporate.
That marked the second time this yr that the insurer’s Medicare Benefit enterprise has come below federal scrutiny. The Journal additionally reported in February that the DOJ is conducting a civil investigation into whether or not the corporate inflated diagnoses to set off additional funds to its Medicare Benefit plans.
However on Thursday, UnitedHealth mentioned unbiased audits by the Facilities for Medicare and Medicaid Companies “verify” that the corporate’s practices are “among the many most correct within the business.”
UnitedHealth additionally pointed to a particular grasp’s advice in March in favor of the corporate in a yearslong authorized battle with the DOJ that started with a whistleblower who alleged the corporate illegally withheld at the very least $2 billion via the Medicare Benefit program. The particular grasp assigned to the case by a choose mentioned the DOJ lacked proof.
UnitedHealthcare’s Medicare and retirement phase, which incorporates the Medicare Benefit enterprise, is UnitedHealth Group’s largest income driver, raking in $139 billion in gross sales final yr.
The replace within the probe comes after a tumultuous final yr for UnitedHealthcare. Shares of UnitedHealthcare’s guardian firm, UnitedHealth Group, are down greater than 42% for the yr after it suspended its 2025 forecast amid skyrocketing medical prices, introduced the shock exit of Witty and grappled with the reported probe into its Medicare Benefit enterprise.
The corporate’s 2024 wasn’t any simpler, marked by a historic cyberattack and the torrent of public blowback after the homicide of UnitedHealthcare’s CEO Brian Thompson.
— CNBC’s Bertha Coombs contributed to this report.
