UnitedHealth Faces DOJ Probe for Medicare Billing Practices, Shares Down 2%

UnitedHealth, the nation's largest private health insurer, is under a Department of Justice investigation for its Medicare billing practices, adding to the company's recent problems. Shares were 2% lower on Thursday morning. The investigation focuses on improper inflated patient diagnoses and the company's HouseCalls program. UNH has cooperated with the DOJ and maintains confidence in its Medicare Advantage program.

UnitedHealth Group Inc. (NYSE: UNH), the nation's largest private health insurer, is under a Department of Justice (DOJ) investigation for its Medicare billing practices. The investigation, which focuses on improperly inflated patient diagnoses and the company's HouseCalls program, has added to the company's recent problems. Shares were 2% lower on Thursday morning. UnitedHealth has cooperated with the DOJ and maintains confidence in its Medicare Advantage program [1].

The DOJ probe, which began at least a year ago, is drawing fresh scrutiny as former employees speak with federal investigators. The Wall Street Journal reported that former UnitedHealth employees told investigators that the company encouraged the capture of certain lucrative diagnoses during patient assessments. These efforts included testing patients, implementing protocols to document medical conditions, and dispatching nurses to conduct in-home evaluations [4].

In May, UnitedHealth was reportedly investigated by the DOJ for possible Medicare fraud. The company responded by stating that it had not been notified of the supposed criminal investigation reported in the Wall Street Journal and maintained its stance that it stands by the integrity of its Medicare Advantage program [1].

UnitedHealth has been facing mounting challenges this year, including the suspension of its 2025 forecast amid skyrocketing medical costs, the surprise exit of former CEO Andrew Witty, and the reported probe into its Medicare Advantage business. The company's 2024 was marked by a historic cyberattack and public backlash following the murder of UnitedHealthcare's CEO Brian Thompson [1].

The investigation comes after a tumultuous year for UnitedHealthcare, the company's largest revenue driver, which raked in $139 billion in sales last year. UnitedHealth Group shares are down more than 42% for the year after the company withdrew its financial outlook and appointed former CEO Stephen Hemsley to return as CEO [1].

UnitedHealth is set to report second-quarter results next week and is expected to establish new financial targets for the year. The company's Medicare and retirement segment, which includes the Medicare Advantage business, is its largest revenue driver [3].

References:
[1] https://www.cnbc.com/2025/07/24/unitedhealthcare-doj-investigation-medicare-billing.html
[2] https://www.morningstar.com/news/dow-jones/202507247740/unitedhealth-group-reaches-out-to-justice-department-amid-reports-of-medicare-billing-probe
[3] https://news.bloomberglaw.com/health-law-and-business/unitedhealth-is-cooperating-with-doj-medicare-business-probes
[4] https://finance.yahoo.com/news/unitedhealth-former-staff-reveal-dark-080243256.html