The hits keep coming for UnitedHealth Group.
Just days after the company announced a change at the top and the suspension of its 2025 outlook, a new media report suggests its health insurance division is facing a criminal fraud investigation.
Individuals close to the matter told The Wall Street Journal that the Department of Justice (DOJ) has actively been investigating UnitedHealthcare for fraud since at least last summer, with a focus on its Medicare Advantage (MA) business. Further details on particular criminal allegations are unclear, according to the article.
UHG told the WSJ that it is unaware of any criminal investigation, and the DOJ declined to comment on the matter, per the article.
The purported criminal investigation follows an antitrust probe into the healthcare giant, with federal investigators particularly digging into the relationship with UnitedHealthcare and Optum. UHG has historically argued that as Optum sells its services to other payers, sharing sensitive data with UnitedHealthcare or otherwise colluding with the insurance arm would not be in its best interest.
The feds are also conducting a civil investigation into the company’s MA billing practices, and it has taken heat from policymakers over its behavior in this market.
It’s been a rough start to 2025 for UnitedHealth, which posted an uncharacteristically bad financial performance in the first quarter. The company reported that medical costs far exceeded its expectations and are expected to be a drag on its earnings for the remainder of the year.
Earlier this week, the company revealed that CEO Andrew Witty would step down from his role, with former CEO Stephen Hemsley returning to the post in his stead. It also suspended its guidance for the year as it grapples with elevated utilization trends.
UnitedHealth’s stock has been in a slump since it released its earnings in mid-April, with shares sliding further following the news of Witty’s departure. It’s currently trading at the lowest value in several years.
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