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by Kristin Rowan, Editor
DOJ Investigates UnitedHealth for Possible Medicare Fraud
DoJ investigates UnitedHealth Group for Medicare fraud, according to an exclusive article from The Wall Street Journal yesterday. The news was reported to the Wall Street Journal by anonymous sources. According to the story, the investigation has been ongoing since last summer. This investigation is in addition to a civil fraud investigation on Medicare billing practices, alleging more than $2 billion worth of unsupported diagnoses.
UnitedHealth Group Denies Investigation
UnitedHealth Group issued a statement directed at the Wall Street Journal following the publication of the alleged investigation.
“We have not been notified by the Department of Justice of the supposed criminal investigation reported, without official attribution, in the Wall Street Journal today. The WSJ’s reporting is deeply irresponsible, as even it admits that the ‘exact nature of the potential criminal allegations is unclear.’ We stand by the integrity of our Medicare Advantage program.”
Shareholders May Disagree
The Wall Street Journal article coincides with reports that UnitedHealth Group shareholders filed a request asking the company to prepare a report on the risks associated with denying care. Specifically, shareholders mentioned “public health-related costs and macroeconomic risks created by the company’s practices that limit or delay access to healthcare.”
Board Concerns
Public outcry since the death of Brian Thompson may have contributed to the board’s concerns. The request acknowledged that certain practices and policies may increase short-term revenue, but threaten the brand’s reputation and investor portfolios. Only partially concerned with the health and well-being of the company’s beneficiaries, the shareholders also noted higher consumer debt, reduced workforce productivity (because of the risk to the health of policyholders), and increased taxes. Among the practices the shareholders want reports on are authorization requirements that deny or delay care and deny care to increase profit.
No Comment
UnitedHealth Group has not commented on the shareholder filings and they may or may not grant the request for a report. A statement from December 2024 may provide insight into the company’s position. It said, “UnitedHealthcare approves and pays about 90 percent of medical claims upon submission. Importantly, of those that require further review, around one-half of one percent are due to medical or clinical reasons. Highly inaccurate and grossly misleading information has been circulated about our company’s treatment of insurance claims.”
Winds of Change
This is an ongoing story and The Rowan Report will continue to provide updates. In the meantime, previous statements from UnitedHealth may no longer be valid. Earlier this week, CEO Andrew Witty abruptly stepped down from his position. Read the accompanying article from The Rowan Report here.
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Kristin Rowan has been working at The Rowan Report since 2008. She is the owner and Editor-in-chief of The Rowan Report, the industry’s most trusted source for care at home news, and speaker on Artificial Intelligence and Lone Worker Safety and state and national conferences.
She also runs Girard Marketing Group, a multi-faceted boutique marketing firm specializing in content creation, social media management, and event marketing. Connect with Kristin directly kristin@girardmarketinggroup.com or www.girardmarketinggroup.com
©2025 by The Rowan Report, Peoria, AZ. All rights reserved. This article originally appeared in The Rowan Report. One copy may be printed for personal use: further reproduction by permission only. editor@therowanreport.com
