The US Department of Justice is conducting a criminal investigation into UnitedHealth Group, the largest health insurer in the US, for possible Medicare fraud, according to the Wall Street Journal.
The investigation focuses on UnitedHealth’s Medicare Advantage business practices. The probe has been active since at least last summer, and is being led by the DOJ’s healthcare fraud unit, according to the Wall Street Journal report, which cited unnamed sources.
UnitedHealth has a large footprint in Alaska, providing Medicare Advantage plans and other health insurance products. Alaska residents enrolled in these plans could be indirectly affected if the investigation leads to a settlement or changes in UnitedHealthcare’s billing practices or plan offerings.
The exact nature of the potential criminal allegations remains unclear, but the investigation follows a separate civil fraud probe launched earlier this year into whether UnitedHealth inflated diagnoses to trigger extra payments for its Medicare Advantage plans.
UnitedHealth has not been formally notified by the DOJ of the criminal investigation and called the WSJ’s reporting “deeply irresponsible.”
UnitedHealth’s stock plunging up to 18% on Thursday, hitting a five-year low and contributing to a 49% year-to-date decline.
This alleged investigation adds to other federal inquiries, including an antitrust case and shareholder lawsuits alleging the company downplayed risks.
The developments coincide with recent turmoil at UnitedHealth, including the abrupt resignation of CEO Andrew Witty and the high-profile assassination of its insurance division head, Brian Thompson, in December.
UnitedHealthcare has significantly gained market share after Obamacare (Affordable Care Act) passed in 2010. The ACA created health insurance marketplaces (exchanges) where individuals and families could purchase coverage, often with taxpayer-funded subsidies.
UnitedHealthcare expanded its presence in these marketplaces, growing from 11 states in 2021 to 30 states by 2025, covering over 1,250 counties. In 2024, 90% of UnitedHealthcare’s ACA marketplace plan members are on subsidies, with over half paying $0 monthly premiums, making these plans attractive and driving enrollment. The ACA business side is separate from the Medicare side of the business.
While UnitedHealthcare does not offer individual ACA marketplace plans in Alaska, it provides group-based plans for employers and unions.
More fraud in the insurance racket? Shocked again as usual.
I just received my portion of a payout from a civil penalty judgement from Blue cross/Blue shield I was previously enrolled in and now insured have been bamboozled again?
My guess is it will be getting more and more difficult keeping a CEO in the hot seat without declining health issues.
Body armor issued maybe an OSHA requirement?
Fraud by doctors and hospitals committing Medicaid fraud?
I am shocked. Shocked I tell you.
A few million dollar donation to the correct presidential library fund will make it all disappear.
Yeah right. Obama’s library definitely needs it. Years behind and millions over budget due to strict DEI hiring practice.
Without help it may never become a library but could be repurposed as another prison for Joe’s imported criminal MS13 gangsters.
The entire pharma industry is a fraud. Pharma companies take natures power and change the chemical structure to something they can patent. Then they sell their drugs for prices so high you can only buy them with an expensive insurance plan or medicaid. People’s health has become a profit center while cures are never provided to those with chronic disease and illness. A great example of the pharma price gouging can be observed in just insulin alone. Wanna stay out of medical debt? Then stay away from western medicine. Take care of your own health. Don’t eat poisoned processed foods. Don’t drink excessively. Turn off the TV!
“taking nature’s power and change the chemical structure”
A) if you change the chemical structure it is no longer the same substance and
B) natural products do not have reliable and consistent amounts of medicinal compounds. Just because something is “natural” does not mean it does not have side effects or is poison at a certain concentration.
Western medicine has raised the standard of living and survival considerably. There are things like sterile operating procedures, sanitation, organ transplants and many other western medical products that keep people alive much longer than previously.
There is a distinct difference between western medicine and corporate exploitation. NO, I am not a fan or employed by big pharma. I just don’t appreciate un-nuanced advice like yours!
Good job A Taxpayer. Thinking for yourself.
It is this pushback that reveals a conversation that keeps minds open.
Keep it up!
What conversation?
You make no argument to defend/expand your position, so we can both have a rational debate. Instead you give me the proverbial sanctimonious pat on the head.
This indicates to me that your are not interested in a “conversation” or “keeping an open mind”. Clearly you have no argument to contribute to that conversation you highlight, after making unsubstantiated declarative statements on how everyone should live in your original post
Obervening; you really have zero self awareness.
Excellent, timely reference to “Red on Blue…”.
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Wilson-Tavoliero ticket? Why not?
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“Ready for war” is good., but on’t forget a significant piece of the opposition is the Democrat controlled judiciary.
Every insurance company on the planet is crooked
Well, that says SOMETHING about DOJ under FJB, doesn’t it. I can’t believe Merrick Garland sanctioned this; these must be rogue investigators. And they really need to find the leak and plug it. UHC makes a point when they called ‘the WSJ’s reporting “deeply irresponsible.” ‘ The DOJ should have notified UHC and public at roughly the same time. If they’re innocent, they’ve nothing to hide. If guilty, there is no safe place TO hide.
Hmmm, who knew there was Medicare Advantage in Alaska? My life is definitely being shortened because of my only having Medicare. I only wish my husband hadn’t died, I would still be covered by his municipal firefighter insurance.
Just for your information Medicare Advantage Plans are not available in the State of Alaska.
Shocked? Don’t be.
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