Report: UnitedHealth under investigation by DOJ for criminal fraud
Three months after claiming the U.S. Department of Justice (DOJ) was investigating UnitedHealth Group over its potentially illegal Medicare billing practices, the Wall Street Journal has released a new report with some additional details.
According to the outlet’s exclusive, the DOJ has been investigating UnitedHealth since last summer, under suspicion the company has committed criminal fraud, possibly linked to its Medicare Advantage business.
Whether or not this investigation is related to the report released in February is unknown, as the specifics of any investigation are still largely a mystery. The Wall Street Journal cites multiple sources familiar with the investigation as the basis for its claims.
Reporters said the DOJ declined to confirm whether an investigation was ongoing, and UnitedHealth released a statement saying it only learned about the case when the report was published on Wednesday.
“We have not been notified by the Department of Justice of the supposed criminal investigation reported, without official attribution, in the Wall Street Journal today," a spokesperson said. "The WSJ’s reporting is deeply irresponsible, as even it admits that the exact nature of the potential criminal allegations is unclear.”
A spokesperson quoted in the report said the company stands by “the integrity of our Medicare Advantage program.”
According to the outlet, the DOJ’s criminal healthcare fraud department is conducting the probe. These units typically focus on crimes that involve kickbacks that trigger higher payments from Medicare claims. In this particular case, it’s the agency's criminal fraud unit out of New York conducting the investigation, sources said.
On a related note, journalists cite a March 11 email from UnitedHealth, leaked by an investor, that seemed to confirm the company is aware of some kind of suspicion of civil or criminal law violations. The email, allegedly written by an attorney with the company, said “the government has asked us some questions regarding Optum’s coding practices,” notifying recipients they could possibly be contacted by officials in relation to an investigation that's “in the early stages.”
For more, read the Wall Street Journal’s report at the link below.
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.