UnitedHealth Group Faces Probe Over Prescription Management Services: Bloomberg

The Department of Justice is investigating UnitedHealth Group's prescription management services, according to Bloomberg News. UnitedHealth, a leading US healthcare supplier, generates revenue from health insurance (55%), prescription management services (41.3%), and computer services (3.7%). The investigation likely relates to the company's Optum Health and Optum Rx units, which provide administrative management, drug distribution, and decision-making information services.

The U.S. Department of Justice (DOJ) is expanding its investigation into UnitedHealth Group Inc., one of the leading healthcare providers in the United States. According to sources familiar with the matter, the DOJ is scrutinizing not only UnitedHealth's Medicare fraud but also its prescription management services and the reimbursement practices for its own doctors. This broader probe indicates a deeper level of scrutiny into the company's operations [1].

UnitedHealth, which generates revenue from health insurance (55%), prescription management services (41.3%), and computer services (3.7%), has been under investigation for its Medicare Advantage billing practices and potential civil antitrust issues. The company has also faced a lawsuit by the U.S. Federal Trade Commission (FTC) alleging that it and two rival pharmacy benefits managers drove up insulin prices [2].

The DOJ's probe is focusing on UnitedHealth's Optum Rx, one of the top three pharmacy benefit managers in the U.S., and its Optum Health division, which includes clinics, surgery centers, and home care services. Optum Rx, which serves patients on UnitedHealthcare insurance plans and external customers, had $133 billion in revenue last year [2].

The company has expressed confidence in its practices, stating that it has been vindicated by audits by the Centers for Medicare and Medicaid Services and has pointed to a favorable development in a long-running civil Medicare fraud case. However, the broader scrutiny of its operations could complicate matters for UnitedHealth. The company's shares have fallen as much as 3.5% in response to the news [2].

UnitedHealth has been undergoing significant internal changes, including the resignation of its CEO, Andrew Witty, and the appointment of former CEO Stephen Hemsley as board chair. Hemsley is leading a management shakeup to restore investor confidence and has formed a new committee to oversee regulatory and reputational risks, including the company's pharmacy benefits management practices [2].

References:
[1] https://news.bloomberglaw.com/white-collar-and-criminal-law/unitedhealth-ongoing-criminal-probe-is-broader-than-medicare
[2] https://www.bloomberg.com/news/articles/2025-08-26/unitedhealth-ongoing-criminal-probe-is-broader-than-medicare