UnitedHealth Group has been under criminal investigation for possible Medicare fraud | Company Business News

Unitedhealth’s investigation contributes to a list of government inquiries facing the company. The Justice Department is investigating Unitedhealth Group for possible criminal Medicare fraud, people who are familiar with the case said. The unit of the healthcare fraud of the criminal division of the Justice Department oversees the investigation, people said, and this has been an active investigation since at least last summer. Although the exact nature of the potential criminal allegations against UnitedHealth is unclear, people said the federal investigation is focusing on the company’s Medicare Advantage business practices. UnitedHealth did not respond to written questions on Wednesday. A doj spokesman declined to comment. The investigation contributes to a list of government inquiries into the company, including investigations into possible violations against antitrust and a civil investigation into the Medicare invoice practices, including the doctor’s offices. UnitedHealth is trying to recover from a collapse of his share on his financial performance and the sudden substitute this week of his CEO, Andrew Witty, with its chairman and former CEO Stephen Hemsley. UnitedHealth’s share has dropped by almost 50% over the past month. Last year, the company faced a hack of a technology unit that disrupted payments to many US health providers for months, and the death of its top executive. All this comes because the Trump administration and congress want to reduce federal health spending, an important source of UnitedHealth’s success. In March, US Senators Mehmet Oz, now the Medicare and Medicaid Agency Head, roasted during his confirmation hearing on the findings of a Wall Street Journal investigation into Medicare Advantage Insurers such as UnitedHealth. Oz promised a suppression. The criminal investigation may pose an extra challenge for UnitedHealth amid an in -depth confidence among shareholders, regulators and clients. The Department of Justice Criminal Fraud Unit focuses on crimes such as setbacks causing higher payments for Medicare and Medicare. The fraud unit has offices in more than a dozen cities, but is managed from DOJ’s headquarters in Washington, DC prosecutors are working on the criminal investigation of UnitedHealth of the New York fraud unit, the people who are familiar with the investigation said. Andrew Witty, then CEO of UnitedHealth, testified in May 2024 before a Senate Committee looked at burglary. For many years, the unit focused on brushing doctors, laboratories and other service providers who brush government health programs and insurers too much. But the unit focused on insurers in the Medicare Advantage system, where they now oversee taxpayer-funded benefits for more than half of the seniors and disabled people in the wider Medicare program, people who are familiar with the case said. Medicare Advantage insurers are paid extra for the deck of sicker patients, creating an incentive to document diagnoses for patients they cover. In some cases, the reporting of the magazine showed, questionable diagnoses by Unitedhealth added billions of rands to the cost of taxpayers. The company disputed the findings of the magazine, saying that its analysis was ‘inaccurate and biased’, and that Medicare Advantage ‘provides better health outcomes and more affordable healthcare for millions of seniors’ than traditional Medicare. The latest annual filing of Securities in UnitedHealth says the company “was involved or is currently involved in various government investigations, audits and judgments,” and flags involved, including the Justice Department. It is not specifically mentioned that the criminal, civil and antitrust investigations reported the magazine. UnitedHealth rejected a report by Wall Street Journal in February in which he unveiled the civil investigation into the Medicare fraud of the company as “wrong information” and said it was not aware of a “new” investigation. In ‘NE -mail of March 11, which appears in a lawsuit by an investor in UnitedHealth, a lawyer from the company who acknowledged that’ the government has asked us a few questions regarding Optum’s coding practices, ‘with reference to the Medicare invoice practices of UnitedHealth’s Healthcare Services ARM, which includes his doctor groups. The email, who warned a former Unitedhealth employee about the possibility of being contacted by the government, described the investigation as ‘in the early stages’. A spokeswoman for UnitedHealth said last week that the company stood against its statement from February and refused to comment on the email. In the past, the doj struggled to make its case in fraud claims against UnitedHealth. In March, a special master appointed by the court recommended that a judge rejects a whistle-blower case against Unitedhealth effectively after the government concluded that the government did not prove that the patient diagnosis filed for payment was inaccurate. The judge in the case has not yet decided on the recommendation. The civil case, brought by a former Unitedhealth employee, became a whistleblower in 2011 and joined the government in 2017, and was involved that UnitedHealth diagnoses recorded by doctors filed that its own judges were not supported by patient medical cards. The doj asked the judge to reject the recommendation of the special master. UnitedHealth said the finding showed that there was no evidence to support the doj’s allegations that we paid too much or that we did something wrong. ‘President Trump and Mehmet Oz, the head of the Medicare-Medicaid Agency who promised a suppression of some Medicare Advantage insurers’ practices. Write to Christopher Weaver at [email protected] and Anna Wilde Mathews at [email protected] UnitedHealth Group is under criminal investigation for possible Medicare Fraud Unitedhealth Group is under a criminal investigation for possible Medicare fraud Disclaimer: Text.