UnitedHealth Is Under Review For Unethical Coding Practices
Shares of UnitedHealth Group dipped Thursday after the company revealed it is under investigation by the Department of Justice, according to CBS News. In a Securities and Exchange Commission filing, the healthcare giant stated: "(UnitedHealth) has a long record of responsible conduct and effective compliance," while confirming it has begun complying with federal investigators' criminal and civil requests.
The investigation follows a Wall Street Journal report earlier this year about a civil fraud probe into UnitedHealth's Medicare Advantage (MA) practices. The Journal reported federal officials were examining how the company records diagnoses that generate additional payments for its MA plans, which serve over 8 million people, making UnitedHealthcare the nation's largest MA provider.
In February, UnitedHealth Group Inc. said it "wasn't aware of the start of any new activity" regarding the reported investigation. However, Thursday's filing noted the company proactively "reached out to the Justice Department after reviewing media reports about investigations into certain aspects of the company's participation in the Medicare program."
In 2024, the company’s head admitted their systems had some faults.
“No one would design a system like the one we have. And no one did. It’s a patchwork built over decades. Our mission is to help make it work better,” Andrew Witty wrote in a New York Times op-ed, titled "The Health Care System Is Flawed. Let’s Fix It."
The Medicare Advantage business has faced challenges recently due to "rising care use and rate cuts," as reported by CBS News. UnitedHealth operates multiple healthcare divisions including a major insurance arm, pharmacy benefits management services, and its growing Optum segment that provides "care and technology support."
The company's stock has trended downward since December, when UnitedHealthcare CEO Brian Thompson was fatally shot in midtown Manhattan while going to the company's annual investor meeting.