MINNETONKA, Minn. — UnitedHealth Group revealed Thursday that it is cooperating with criminal and civil investigations by the U.S. Department of Justice (DOJ) into its Medicare billing practices, marking a significant development in a turbulent period for the nation’s largest private health insurer.
In a regulatory filing, UnitedHealth confirmed that it has received formal requests from the DOJ and has proactively engaged with the department following initial reporting by the Wall Street Journal in May. The company emphasized it has “full confidence in its practices” and is “committed to working cooperatively” with federal investigators.
"(UnitedHealth) has a long record of responsible conduct and effective compliance," the company said in a Securities and Exchange Commission filing.
To bolster transparency, UnitedHealth has initiated an independent third-party review of its internal policies, coding protocols, and performance metrics. The review is expected to conclude by the end of the third quarter.
The announcement follows recent reporting from The Wall Street Journal indicating that the DOJ is conducting both criminal and civil probes into whether UnitedHealth manipulated diagnoses to increase Medicare Advantage reimbursements. The Journal also noted that several physicians were interviewed about potential pressure to upcode conditions that would justify higher federal payments.
Despite these inquiries, UnitedHealth defended its record, citing audits by the Centers for Medicare & Medicaid Services (CMS) that it says confirm its practices are “among the most accurate in the industry.” The company also pointed to a recent recommendation by a court-appointed special master that found the DOJ lacked evidence in a whistleblower case alleging $2 billion in improper Medicare Advantage payments.
UnitedHealth’s Medicare and retirement segment generated $139 billion in revenue last year, making it the company’s largest division. The business has faced scrutiny in recent months over rising medical costs, CMS rate adjustments, and increasing regulatory pressure.
The news comes amid broader instability at the company. In May, CEO Andrew Witty stepped down unexpectedly, months after the tragic shooting death of UnitedHealthcare CEO Brian Thompson in Manhattan. UnitedHealth has also grappled with the fallout from a major cyberattack earlier this year and was forced to suspend its 2025 forecast due to a surge in care utilization.
Shares of UnitedHealth Group (NYSE: UNH) fell more than 4% Thursday morning to $287.39—down over 50% from its December high. Investors are expected to seek more clarity when the company reports second-quarter earnings on July 29.
UnitedHealth reiterated its commitment to compliance, stating that it aims to “serve as reliable stewards of American tax dollars” and maintain the integrity of its Medicare Advantage operations amid ongoing federal scrutiny.
