DOJ investigation of UnitedHealth confirmed in SEC filing
UnitedHealth Group said Aug. 14 its Medicare Advantage programs are indeed being investigated by the U.S. Department of Justice (DOJ), confirming multiple reports from the Wall Street Journal.
In a filing with the Securities and Exchange Commission (SEC), the insurance giant revealed that it was complying with the DOJ, which had made “formal criminal and civil requests.” It said it had reached out to investigators after reviewing media reports.
In May, following the initial Wall Street Journal report, a spokesperson for UnitedHealth called the coverage of the "supposed" criminal investigation "deeply irresponsible."
When the outlet followed up in July with a report that claimed the DOJ had been questioning doctors about the company’s Medicare Advantage billing practices, UnitedHealth said it welcomed the audit by regulators.
“[UnitedHealth] has full confidence in its practices and is committed to working cooperatively with the Department throughout this process,” it reiterated in its statement to the SEC, adding that it stands by its “long record of responsible conduct and effective compliance.”
“The company is committed to maintaining the integrity of its business practices and serving as reliable stewards of American tax dollars,” UnitedHealth wrote.
Probe may involve multiple agencies
According to the Wall Street Journal, the DOJ is working with the Federal Bureau of Investigation (FBI) and the HHS Office of Inspector General (OIG) to look into claims of upcoding, where doctors may have diagnosed patients with long-term conditions that earn more government subsidies for UnitedHealth’s Medicare Advantage plans.
The specifics are largely unknown, and there have been no lawsuits or indictments filed against anyone at the company.
UnitedHealth Group stock dropped 5% after the SEC filing.
Chad is an award-winning writer and editor with over 15 years of experience working in media. He has a decade-long professional background in healthcare, working as a writer and in public relations.