News Alert: DOJ Investigates UnitedHealth’s Medicare Billing Practices
March 6, 2025
The U.S. Department of Justice (DOJ) has launched a civil fraud investigation into UnitedHealth Group’s Medicare billing practices. The probe focuses on whether the company improperly recorded diagnoses to increase payments for its Medicare Advantage plans, including activities within its physician groups.
UnitedHealth Group is the largest healthcare company in the U.S., operating through its insurance division, UnitedHealthcare, and its healthcare services arm, Optum. It provides health insurance plans, including Medicare Advantage, and manages healthcare services through a vast network of providers, clinics, and data-driven healthcare solutions. The company plays a major role in the U.S. healthcare system but has faced scrutiny over billing practices and regulatory compliance.
Reports indicate that UnitedHealth received billions in payments for questionable diagnoses, including conditions that patients were never treated for. The investigation follows ongoing scrutiny of Medicare Advantage billing practices, which have been the subject of audits and whistleblower lawsuits.
UnitedHealth has denied any wrongdoing, stating that it is unaware of new DOJ activity and that its billing practices comply with regulations.
This investigation comes amid separate antitrust scrutiny of UnitedHealth, as the DOJ seeks to block the company’s $3.3 billion acquisition of home-health provider Amedisys.