UnitedHealth Group (UNH) Faces Investor Scrutiny After Wall Street Journal Report of Justice Department Probe Into Medicare Billing Practices - Hagens Berman

SAN FRANCISCO, Feb. 27, 2025 /PRNewswire-PRWeb/ -- On February 21, 2025, the price of UnitedHealth Group Incorporated (NYSE: UNH) shares tumbled $36 (-7%) after the Wall Street Journal reported that the DOJ launched a new civil fraud investigation examining UnitedHealth's practices for recording diagnoses that trigger extra payments to its Medicare Advantage plans, including at physician groups the company owns.

Hagens Berman is investigating the possible misconduct and urges investors who purchased UnitedHealth shares and suffered substantial losses to submit your losses now.

Visit: www.hbsslaw.com/investor-fraud/unh
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UnitedHealth Group (UNH) Investigation:

The investigation is focused on whether UnitedHealth Group may have improperly billed the federal government for services purportedly provided to Medicare Advantage enrollees and, if so, whether the company may have recorded illegal revenues in its financial statements.

The company's business practices may have come into question on February 21, 2025, when the WSJ published a blockbuster report titled "DOJ Investigates Medicare Billing Practices at UnitedHealth." According to the report "Doctors said UnitedHealth […] trained them to document revenue-generating diagnoses, including some they felt were obscure or irrelevant[]" and "[t]he company also used software to suggest conditions and paid bonuses for considering the suggestions, among other tactics, according to the doctors." 

The market reacted swiftly that day, sending the price of UnitedHealth Group shares down $36 (-7%), wiping out over $33 billion of shareholder value in a single trading day.

Then, on February 24, 2025 Senator Chuck Grassley, Chairman of the Senate Committee on the Judiciary, wrote to UnitedHealth CEO (Andrew Witty) demanding to know what steps the company has taken to review all diagnoses submitted to the Centers for Medicare & Medicaid Services ("CMS") for its Medicare Advantage enrollees that were identified only by the company's in-home health risk assessments ("HRAs"). Senator Grassley further demanded, in part, that UnitedHealth "identify all  submitted diagnoses that are obscure, irrelevant, or inaccurate[]" and to "[q]uantify the number and amount of inappropriate payments identified as a result of these actions."

In addition to the WSJ reporting, Senator Grassley referenced a previous October 2024 report by the Department of Health and Human Services Office of Inspector General ("HHS OIG") titled "Medicare Advantage: Questionable Use of Health Risk Assessments Continues to Drive Up Payments to Plans by Billions." According to the Senator:

• "HHS OIG found that UnitedHealth Group received more money from CMS for diagnoses only made during in-home HRAs and chart reviews than any other MAO [Medicare Advantage Organization]."
• "The OIG, which reviewed all MAO enrollees noted that, 'the lack of any other follow-up visits, procedures, tests, or supplies for these diagnoses…raises concerns that either: (1) the diagnoses are inaccurate and thus the payments are improper or (2) enrollees did not receive needed care for serious conditions reported only on HRAs or HRA-linked chart reviews.'"
• "The apparent fraud, waste, and abuse at issue is simply unacceptable and harms not only Medicare beneficiaries, but also the American taxpayer."

"We are concerned that UnitedHealth may have misled investors about the legality of its Medicare Advantage practices and associated revenues," said Reed Kathrein, the Hagens Berman Partner leading the firm's probe.

If you invested in UnitedHealth Group and have substantial losses, or have knowledge that may assist the firm's investigation, submit your losses now »

If you'd like more information and answers to frequently asked questions about the UnitedHealth Group investigation, read more »

Whistleblowers: Persons with non-public information regarding UnitedHealth Group should consider their options to help in the investigation or take advantage of the SEC Whistleblower program. Under the new program, whistleblowers who provide original information may receive rewards totaling up to 30 percent of any successful recovery made by the SEC. For more information, call Reed Kathrein at 844-916-0895 or email [email protected].

About Hagens Berman
Hagens Berman is a global plaintiffs' rights complex litigation firm focusing on corporate accountability. The firm is home to a robust practice and represents investors as well as whistleblowers, workers, consumers and others in cases achieving real results for those harmed by corporate negligence and other wrongdoings. Hagens Berman's team has secured more than $2.9 billion in this area of law. More about the firm and its successes can be found at hbsslaw.com. Follow the firm for updates and news at @ClassActionLaw. 

SOURCE Hagens Berman Sobol Shapiro LLP