UnitedHealth Group has confirmed it is under both criminal and civil investigation by the Department of Justice over its Medicare billing practices. In a recent securities filing, the company disclosed that it has begun cooperating with the DOJ and initiated a third-party review of its internal policies and performance metrics. The review is expected to be completed by the end of the third quarter.
UnitedHealth stated it remains confident in its practices and is fully committed to working with federal authorities throughout the process. Despite this assurance, shares of the company fell approximately 2% following the announcement, adding to a year of steep losses. Investors and analysts expect further clarity during the company’s upcoming second-quarter earnings call on July 29.
This disclosure comes after reports earlier this year that federal prosecutors are examining whether UnitedHealth improperly influenced doctors to submit certain diagnoses, which in turn boosted reimbursements under the Medicare Advantage program. The allegations suggest the company may have inflated the severity of patient conditions to maximize federal payouts.
This marks the second federal investigation into UnitedHealth’s Medicare operations in 2025. A civil inquiry earlier this year also looked into potential overbilling practices tied to diagnostic coding. Despite the scrutiny, UnitedHealth cited audits from the Centers for Medicare and Medicaid Services that reportedly confirm its coding accuracy ranks among the highest in the industry. The company also referenced a special master’s March recommendation in a longstanding DOJ case, which concluded the government lacked sufficient evidence to support claims that UnitedHealth withheld at least $2 billion in Medicare funds.
The Medicare Advantage business is a cornerstone of UnitedHealth’s operations, generating $139 billion in revenue last year from the Medicare and retirement segment alone. The outcome of these investigations could significantly impact the company’s financial and operational outlook.
UnitedHealth is also facing broader challenges. The company has experienced a 42% stock decline year-to-date, suspended its 2025 guidance due to soaring medical costs, and saw the unexpected departure of CEO Andrew Witty in May. This followed an already difficult 2024, which included a damaging cyberattack and widespread backlash after the high-profile murder of UnitedHealthcare CEO Brian Thompson.
As investigations continue and leadership transitions unfold, UnitedHealth faces mounting pressure to stabilize operations and reassure stakeholders amid legal and reputational challenges.
READ MORE: