The U.S. Department of Justice (DOJ) is conducting a criminal investigation into UnitedHealth Group concerning potential Medicare fraud, according to a report by the Wall Street Journal on Wednesday.
UnitedHealth stated that it had not received notification from the DOJ regarding the “supposed criminal investigation reported” and defended “the integrity of our Medicare Advantage program.” Following the report, the company’s stock fell 8% in after-hours trading.
The health insurer has been facing increased scrutiny in recent months. On Tuesday, UnitedHealth Group’s CEO, Andrew Witty, unexpectedly stepped down, and the company simultaneously suspended its 2025 financial forecast due to rising medical costs. This announcement caused shares to plummet nearly 18% to a four-year low.
Stephen Hemsley, who previously led the company for over a decade until 2017, is returning to his former role. This follows setbacks including the December murder of Brian Thompson, the CEO of its insurance unit.
The DOJ’s healthcare-fraud unit is overseeing the criminal investigation, focusing on the company’s Medicare Advantage business practices, according to the Wall Street Journal. The investigation has been active since at least last summer.
A DOJ spokesperson declined to comment on the new criminal probe.
Last week, United Health disclosed in a filing that it had been “involved or is currently involved in various governmental investigations, audits and reviews,” without providing further details.
In February, the Wall Street Journal reported a civil fraud investigation into UnitedHealth’s Medicare practices, to which the company responded that it was unaware of any new probe.
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Also in February, U.S. Senator Chuck Grassley initiated an inquiry into UnitedHealth’s Medicare billing practices, requesting detailed records of their compliance program and related documents. UnitedHealth shares are down approximately 40% for the year.
This investigation follows broader scrutiny of the Medicare Advantage program.
Earlier this month, the DOJ filed a lawsuit accusing three of the largest U.S. health insurers of paying kickbacks to brokers in exchange for steering patients into their Medicare Advantage plans.
Nearly half of the 65 million people covered by Medicare are enrolled in Medicare Advantage plans run by private insurers. These insurers receive a set rate for each patient, with the possibility of higher payments if patients have multiple health conditions.
Standard Medicare coverage is managed by the government.
