UnitedHealth Group is under investigation by the Department of Justice for alleged Medicare fraud, and the fallout is already shaking the industry. In a report by The Wall Street Journal, the DOJ’s criminal division’s healthcare-fraud unit launched its probe last summer, focusing on whether UnitedHealth Group improperly profited from Medicare Advantage plans through inaccurate diagnosis reporting.
Though the full scope of the criminal allegations remains unclear, insiders familiar with the investigation say it could expose billions in overpayments. The company’s response? Silence. UnitedHealth has yet to issue a public statement about the investigation. But their stock already told the story—dropping 6.7% after the report hit.
What Sparked the UnitedHealth Group Investigation?
The spotlight turned toward UnitedHealthCare earlier this year when the DOJ began digging into how the company documented diagnoses that may have triggered extra payments under the Medicare Advantage program. According to Reuters, the probe intensified in February, when federal officials started questioning whether UnitedHealth had exaggerated medical conditions for financial gain—a practice known as upcoding.
In a parallel shakeup, the company announced a leadership transition, replacing CEO Andrew Witty with board chairman and former CEO Stephen Hemsley. Critics are pointing out the timing, noting that the leadership change closely follows the DOJ’s intensified probe and a steep stock drop of nearly 50% over the past month.
This isn’t the first time a major healthcare company has been accused of shady Medicare Advantage billing practices—but it may be one of the most high-profile to date.
UnitedHealth Group*********** Under Investigation—And The Pressure Is Mounting
The news that UnitedHealthCare is under investigation could mark a turning point in how the U.S. government addresses corporate accountability in healthcare. With billions at stake and millions of patients affected, this case is far more than a financial scandal—it’s a test of integrity for the entire system.
As federal investigators dig deeper, eyes across the medical, legal, and political worlds are watching closely. UnitedHealth has stayed quiet, but their stock drop and executive shakeup say plenty.
