What You Should Know:
– UnitedHealth Group revealed it is facing a Justice Department (DOJ) criminal and civil investigation into its Medicare billing practices, adding to a series of recent setbacks for the nation’s largest and most powerful private insurer.
– The company also announced it has launched a third-party review of its business policies and performance metrics, expected to be completed by the end of the third quarter. The announcement comes after a tumultuous period for UnitedHealthcare, the company’s largest revenue driver through its Medicare and retirement segment, which raked in $139B in sales last year.
DOJ Investigation
In a securities filing, UnitedHealth Group confirmed it is complying with formal criminal and civil requests from the DOJ and proactively reached out to the department after reports of the probes surfaced. The company expressed “full confidence in its practices and is committed to working cooperatively with the Department throughout this process”. UnitedHealth Group shares dropped around 2% on the day of the announcement.
In response to previous reports, UnitedHealth Group maintained its stance on the integrity of its Medicare Advantage program. The company stated that independent audits by the Centers for Medicare and Medicaid Services (CMS) “confirm” that its practices are “among the most accurate in the industry”.
UnitedHealth also pointed to a special master’s recommendation in March in favor of the company in a years-long legal battle with the DOJ. This case stemmed from a whistleblower allegation that the company illegally withheld at least $2Bthrough the Medicare Advantage program, but the special master assigned by a judge found the DOJ lacked evidence.
