Major health insurer facing criminal DOJ probe for possible fraud: report

Federal investigators are investigating a major health insurer for possible criminal Medicare fraud, people familiar with the matter told The Wall Street Journal on Wednesday.

Health care fraud investigators at the Justice Department have been probing UnitedHealth Group since at least the summer of 2024, according to the report.

The probe reportedly centers around the company’s Medicare Advantage business practices, the Journal said, noting the Trump administration has looked to slash federal health spending, which UnitedHealth has benefited from.

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The Journal noted that Medicare Advantage insurers receive more money for covering deeply ill patients. That system has led to "questionable diagnoses" as the insurer is incentivized to document diagnoses for their patients and rake in billions at the taxpayers’ expense.

UnitedHealth has rebuffed the accusations, telling the Journal its analysis is "inaccurate and biased."