July 24, 2025— UnitedHealth Group (NYSE:UNH) shares fell 4% on Thursday morning after the U.S. Department of Justice (DOJ) said it is looking into some parts of the company’s participation in the Medicare program.
UnitedHealth Group said in an SEC statement that it contacted the authorities on its own after reading news reports about investigations into its Medicare involvement. It has now started to follow the DOJ’s formal requests.
The corporation, which is a major player in the U.S. healthcare industry and offers health insurance and runs its own healthcare services segment called Optum, stressed its “long record of responsible conduct and effective compliance.” UnitedHealth said in its filing that independent audits by the Centers for Medicare & Medicaid Services (CMS) show that its methods “are among the most accurate in the industry.” The corporation also mentioned a civil case that lasted ten years and was about its Medicare Advantage operation. A court-appointed Special Master found that there was “no evidence to support claims of wrongdoing.”
To ease any worries that might come up because of this new probe, UnitedHealth has started a program for outside experts to look at its policies, practices, and related processes for risk assessment coding, managed care, and pharmacy services. One thing that CMS looks at closely is risk adjustment coding. This is a way for them to change the payments they make to Medicare Advantage plans based on the health of the people who are enrolled and the medical bills they expect to have. Plans get more money when those with higher risk scores, which are based on proven conditions, sign up.
UnitedHealth Group said it will work closely with the DOJ during the investigative process and promised to keep its business honest and “serve as reliable stewards of American tax dollars.”
The start of official criminal and civil investigations puts UnitedHealth under regulatory pressure, which might affect its value and how investors feel about it until the issues are resolved. The corporation talks about its good history of following the rules and winning legal cases, but the full breadth and length of the current probes are still unknown. Legal costs could go up, and in the worst-case situation, the investigations could lead to fines, restitution, or limits on who can participate in the program.
The government has looked into UnitedHealth Group before. The corporation has been investigated, sued, and fined in the past for a number of things, such as overcharging Medicare, antitrust issues, and unfair claims tactics. The Wall Street Journal reported in May 2025 that there was a criminal investigation for possible Medicare fraud connected to its Medicare Advantage business operations. The probe had been going on since previous summer, according to the paper.