DOJ Probes UnitedHealth, Rivals Over Medicare Fraud

UnitedHealth Group, the largest U.S. provider of Medicare Advantage plans with over eight million members, is under both criminal and civil investigation by the Department of Justice for alleged Medicare fraud and questionable diagnosis coding practices. The probe centers on whether UnitedHealth and other leading insurers, including Aetna and Humana, improperly increased government payments by inflating patient diagnoses, though all companies deny wrongdoing. UnitedHealth states it is complying with DOJ requests and proactively contacted authorities after initial media reports. The company has launched internal reviews while maintaining confidence in its practices. The investigations occur amid a turbulent year for UnitedHealth, including leadership changes and stock declines. This heightened scrutiny reflects broader industry concerns about fraud and overbilling in the private Medicare sector.