The U.S. Department of Justice, led by Attorney General Pam Bondi, has launched an investigation into Medicare billing practices at UnitedHealth Group.
The probe comes just months after the assassination of the company’s chief executive, Brian Thompson.
According to a report from The Wall Street Journal, federal attorneys are looking into alleged civil fraud related to how UnitedHealth Group recorded medical diagnoses that resulted in increased payments to its Medicare Advantage plans.
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The investigation includes potential fraudulent activity within UnitedHealth Group-owned physician groups.
Under the Medicare Advantage system, insurers receive payments that adjust based on the severity of diagnoses recorded.
This structure creates financial incentives to identify more ailments, potentially leading to increased federal reimbursements.
The Wall Street Journal previously reported that UnitedHealth Group had received billions of dollars in Medicare payments for what were described as “questionable diagnoses.”
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As part of the investigation, Justice Department attorneys have begun interviewing medical providers mentioned in the outlet’s prior reporting.
UnitedHealth Group has pushed back against the claims, calling the investigation misleading.
“The government regularly reviews all MA plans to ensure compliance, and we consistently perform at the industry’s highest levels on those reviews,” the company stated in response to the report.
The company also dismissed the idea that any new federal action had been launched.
“We are not aware of the ‘launch’ of any ‘new’ activity as reported by the Journal.”
UnitedHealth further accused The Wall Street Journal of biased reporting, stating, “We are aware, however, that the Journal has engaged in a year-long campaign to defend a legacy system that rewards volume over keeping patients healthy and addressing their underlying conditions.”
“Any suggestion that our practices are fraudulent is outrageous and false,” the company added.
As part of its broader scrutiny of UnitedHealth Group, the Justice Department has filed to block the company’s $3.3 billion acquisition of home healthcare company Amedisys. The move adds to ongoing legal challenges facing the healthcare giant.
The investigation follows the assassination of UnitedHealth Group’s CEO, Brian Thompson, in New York City.
Thompson was shot at point-blank range outside a Manhattan hotel. Police discovered shell casings at the scene with the words “deny,” “defend,” and “depose” inscribed on them.
Following a five-day manhunt, authorities arrested 26-year-old Luigi Mangione, who has been charged with state murder and terror offenses.
He is scheduled to appear in court for the first time since his December arraignment.
UnitedHealth Group’s stock value took a significant hit after Thompson’s death, dropping more than $100 in the following weeks.
As the Justice Department’s investigation into UnitedHealth Group’s billing practices continues, scrutiny remains high on the company’s financial dealings and leadership in the wake of its CEO’s murder.
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