UnitedHealthcare’s Medicare Advantage policies are the subject of an ongoing federal investigation
Healthcare giant says it will work with the DOJ as diagnosis billing is looked at more closely
The Department of Justice is looking into UnitedHealth Group’s Medicare Advantage operations on both a criminal and a civil level, the company said. In a filing with the Securities and Exchange Commission, the company said it is working with government investigators and has already begun doing so.
In its SEC filing, UnitedHealth said, “(UnitedHealth) has a long record of responsible conduct and effective compliance.”
The news caused the stock price to drop 2%, going from $286.50 to $6.13 on Thursday morning.
The DOJ is mostly interested in how UnitedHealthcare records diagnoses for patients in its Medicare Advantage (MA) plans, as this could cause government payments to be inflated. The Wall Street Journal reported earlier this year that the same problem was the subject of a civil fraud investigation by the federal government. UnitedHealthcare is the biggest Medicare Advantage plan provider in the country, with plans that cover more than 8 million people. The segment has been having a hard time with money lately because more people are using healthcare and the government has changed the payment rates.
When news stories about the investigation first came out in February, UnitedHealthcare said they didn’t know about any new behavior. It has since called out to federal authorities, though, after looking into those media claims on its own.
UnitedHealthcare is more than just a health insurance company. It also runs a huge pharmacy benefits manager and the fast growing Optum unit, which provides technology and health services.
The investigation is another setback for the business. Its stock has been falling since December, when New York City police shot and killed UnitedHealthcare CEO Brian Thompson.
