Quotes displayed in real-time or delayed by at least 15 minutes. Market data provided by Factset. Powered and implemented by FactSet Digital Solutions. Legal Statement.
This material may not be published, broadcast, rewritten, or redistributed. ©2025 FOX News Network, LLC. All rights reserved. FAQ – New Privacy Policy
SlateStone Wealth chief market strategist Kenny Polcari discusses whether investors are overreacting to weak market news, on ‘Varney & Co.’
The Department of Justice has reportedly launched a civil fraud investigation into UnitedHealth Group's Medicare billing practices as the company – and the insurance industry as a whole – face increased scrutiny.
The DOJ is looking into how UnitedHealth Group records diagnoses that set off extra payments to its Medicare Advantage plans, sources familiar with the matter told the Wall Street Journal.
Late last year, an analysis by the Journal showed that billions of Medicare records revealed significant increases in lucrative diagnoses for patients seen by UnitedHealth-employed doctors after enrolling in the company’s Medicare Advantage plans.
UnitedHealth said in a statement that the government regularly reviews all Medicare Advantage plans to ensure that they are compliant and that the company performs "at the industry’s highest levels on those reviews."
"Any suggestion that our practices are fraudulent is outrageous and false," UnitedHealth said.
Through Medicare, the federal government’s insurance program, people who are age 65 and older can sign up for Medicare Part A and Part B, which provide hospital and medical insurance. They can also opt for Medicare Part C, also known as a Medicare Ad (Michael Nagle/Bloomberg via Getty Images / Getty Images)
Through Medicare, the federal government's insurance program, people who are age 65 and older can sign up for Medicare Part A and Part B, which provide hospital and medical insurance. They can also opt for Medicare Part C, also known as a Medicare Advantage plan. It is a Medicare-approved plan from a private company that offers an alternative to Original Medicare and includes Part A, Part B and usually Part D, which helps cover the cost of prescription drugs.
SOCIAL MEDIA USERS MOCK UNITEDHEALTHCARE CEO’S MURDER
Justice Department attorneys have been interviewing medical providers cited in the Journal's prior reports exposing how Medicare allegedly paid billions of dollars to UnitedHealth for questionable diagnoses. Those interviews took place as recently as January 31, according to the Journal.
SLAIN UNITEDHEALTHCARE CEO'S WIFE, COMPANY BOSS BREAK SILENCE AFTER EXECUTIVE MURDERED OUTSIDE HOTEL
But the investigation adds to a long list of woes for the company, which has faced an onslaught of public scrutiny over its denials of care even before UnitedHealth CEO Brian Thomposon was gunned down outside a New York City hotel in December in what police have called a "pre-meditated, targeted attack."
A general view outside the UnitedHealthcare corporate headquarters on Dec. 4, 2024, in Minnetonka, Minnesota. (Stephen Maturen/Getty Images / Getty Images)
Last fall, a Senate subcommittee accused UnitedHealthcare Group of denying claims to a growing number of patients as it tried to leverage artificial intelligence to automate the process. The report claimed that UnitedHealthcare’s prior authorization denial rate for post-acute care jumped from 10.9% in 2020 to 22.7% in 2022. United refuted these claims, saying the report "mischaracterizes the Medicare Advantage program and our clinical practices."
GET FOX BUSINESS ON THE GO BY CLICKING HERE
It came around the same time that the DOJ and attorneys general of Maryland, Illinois, New Jersey and New York filed a civil antitrust lawsuit to block UnitedHealth Group's proposed $3.3 billion acquisition of rival home health and hospice services provider Amedisys Inc. over concerns that the deal would threaten care for vulnerable patients and harm home health and hospice nurses.
The Department of Justice declined to comment.
FOX Business reached out to the Department of Health and Human Services’ Office of Inspector General, which is also involved in the investigation, for comment.
Get a brief on the top business stories of the week, plus CEO interviews, market updates, tech and money news that matters to you.
We’ve added you to our mailing list.
By clicking subscribe, you agree to the Fox News Privacy Policy and Terms of Use, and agree to receive content and promotional communications from Fox News. You understand that you can opt-out at any time.
Quotes displayed in real-time or delayed by at least 15 minutes. Market data provided by Factset. Powered and implemented by FactSet Digital Solutions. Legal Statement.
This material may not be published, broadcast, rewritten, or redistributed. ©2025 FOX News Network, LLC. All rights reserved. FAQ – New Privacy Policy