Growing scrutiny of healthcare giants over Medicare practices is reshaping the industry’s landscape, with implications for both market performance and regulatory oversight. This evolving environment has led UnitedHealth Group Inc (NYSE:UNH) to engage with the Department of Justice following reports of ongoing investigations into its Medicare program participation.
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In an SEC filing on Thursday, the company said it has now begun complying with the Department’s formal criminal and civil requests. UnitedHealth says it has full confidence in its practices and is committed to working cooperatively with the Department throughout this process.
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In July, DOJ’s criminal healthcare-fraud unit intensified its investigation into UnitedHealth’s Medicare billing practices, focusing on how it leveraged doctors and nurses to boost government payments.
The probe began at least a year ago and is now drawing fresh scrutiny as former employees speak with federal investigators.
“The company has a long record of responsible conduct and effective compliance. Independent CMS audits confirm that the company's practices are among the most accurate in the industry, and, following a decade-long civil challenge by the Department to aspects of our Medicare Advantage business, a court-appointed Special Master concluded there was no evidence to support claims of wrongdoing,” the company added in the SEC filing.
As previously announced, the company has proactively launched its own initiative to conduct third-party reviews of policies, practices, and associated processes and performance metrics for risk assessment coding, managed care practices, and pharmacy services to provide stakeholders with transparency and confidence in its practices.
Stephen Hemsley, recently appointed CEO, acknowledged the fallout and charted a new course, promising a comprehensive review of some of the company's most controversial practices.
UnitedHealth will release its second quarter 2025 financial results on July 29.
UNH Price Action: UnitedHealth Group shares were down 1.85% at $287.11 at the time of publication on Thursday, according to Benzinga Pro.
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