UnitedHealth Confirms DOJ Probe Into Medicare Billing as Troubles Mount

UnitedHealth Group—the giant behind the country’s largest private health insurer—just confirmed it’s under both criminal and civil investigation by the Department of Justice over its Medicare billing practices.

The company made the disclosure in a regulatory filing on Thursday, saying it’s cooperating with formal DOJ requests and has launched a third-party review of its internal policies and performance benchmarks. That review is expected to wrap up by the end of Q3.

UnitedHealth said it has “full confidence” in how it does business and is “committed to working cooperatively with the Department” as the investigation plays out.

The DOJ is reportedly looking into whether UnitedHealth pressured doctors to bill for conditions that would boost payments through its Medicare Advantage program, a key money-maker for the company.

The Wall Street Journal has been tracking the probe closely and reported that multiple doctors have already been interviewed about potentially inflated diagnoses submitted to Medicare. This is the second time this year UnitedHealth’s billing practices have come under fire.

In response, UnitedHealth says audits from Medicare itself show its billing practices are “among the most accurate in the industry.”

Medicare Advantage is no small slice of the pie. UnitedHealth’s Medicare and Retirement segment pulled in a massive $139 billion in revenue last year. Any DOJ finding could be a big blow not just legally—but financially.

And Wall Street noticed. Shares dipped nearly 2% on Thursday following the announcement.

Let’s be honest—it’s been a rough ride for UnitedHealth lately:

• In May, longtime CEO Andrew Witty made a surprise exit, just as these DOJ reports were heating up.
• The company had to suspend its 2025 forecast amid soaring medical costs.
• A historic cyberattack earlier in the year exposed major security flaws.
• And tragically, UnitedHealthcare CEO Brian Thompson was murdered, sending shockwaves through the industry.

Not to mention that UnitedHealth stock is down over 42% this year, dragging investor confidence with it.

The original story by Annika Kim Constantino for CNBC.