UnitedHealth Group (NYSE:UNH) shares cratered on Thursday, falling over 16% to a five-year low after the Wall Street Journal reported that the healthcare giant is under criminal investigation by the U.S. Department of Justice for possible Medicare fraud.
The revelation deepens the crisis for America’s largest health insurer, which has lost nearly half its market value this year amid leadership turmoil and rising medical costs.
UnitedHealth Group Under DoJ Investigation: Report
According to the Wall Street Journal report, the Justice Department’s healthcare-fraud unit is investigating UnitedHealth’s Medicare Advantage business practices, though the exact nature of the potential criminal allegations remains unclear. The probe has reportedly been active since at least summer 2024.
The DOJ is yet to comment publicly on the matter. This alleged criminal investigation adds to a growing list of government inquiries facing the company, including a civil fraud investigation into its Medicare billing practices and potential antitrust violations.
The Medicare Advantage program, which allows private insurers to manage government-funded healthcare benefits for seniors, has come under increased scrutiny from the Trump administration and Congress.
UnitedHealth’s Stock Down Nearly 50% in Last Month, Wiping Out Billions in Market Value
UnitedHealth’s stock has collapsed by nearly 50% in the past month, wiping out billions in market value. As of 10:23 AM EDT on Thursday, shares were trading at $256.65, down $51.36 (16.68%) for the day, bringing the company’s market capitalization to approximately $232.8 billion.
The stock’s free fall began earlier this week when UnitedHealth abruptly announced CEO Andrew Witty was stepping down, to be replaced by former CEO Stephen Hemsley, while simultaneously suspending its 2025 financial guidance citing rising medical costs. Year-to-date, UNH shares have declined 49.05%, dramatically underperforming the S&P 500’s slight 0.05% decline.
Medicare Advantage insurers like UnitedHealth receive higher payments for covering patients with more documented health conditions, creating incentives that government watchdogs have long scrutinized. The Journal previously reported that questionable diagnoses by UnitedHealth may have added billions to taxpayer costs, though the company disputed these findings.
Potential Consequences for UnitedHealth Group
Criminal healthcare fraud investigations can result in substantial penalties, including fines, remedial measures, and potential exclusion from government programs. However, the DOJ has previously struggled to make fraud allegations against UnitedHealth stick in court.
In March, a court-appointed special master recommended dismissing a whistleblower case against the company after concluding the government hadn’t presented sufficient evidence. The company faces these challenges amid other significant disruptions, including last year’s major technology hack that disrupted healthcare payments nationwide and the December 2024 murder of Brian Thompson, CEO of UnitedHealth’s insurance unit.
Medicare Advantage has become an increasingly important business segment for healthcare insurers, with nearly half of the 65 million Medicare beneficiaries now enrolled in these private plans. The program has grown rapidly as the U.S. population ages, making any disruption to this business potentially devastating for UnitedHealth’s long-term outlook.
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Neither the author, Tim Fries, nor this website, The Tokenist, provide financial advice. Please consult our website policy prior to making financial decisions.
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