UnitedHealth Group Incorporated (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.”

FREQUENTLY ASKED QUESTIONS ABOUT THE CASE

What is the UNH investigation about?

We are concerned that UnitedHealth may have misled investors about the legality of its Medicare Advantage practices and associated revenues.

WHAT SHOULD I DO?

I worked at UNH. What should I do?

If you were an employee of UNH, you may have valuable information that could be relevant to the investigation. Hagens Berman is one of the nation’s top whistleblower law firms, and has successfully represented many individuals who come forward with information regarding corporate malfeasance. Under the new SEC Whistleblower 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, contact Reed Kathrein at 844-916-0895 or [email protected].

There are multiple law firms participating, do I need to contact all of them?

No, you do not need to contact all participating law firms. Generally, class-action investigations and lawsuits are consolidated into a single case to streamline the legal process, and attorneys from only a few law firms are selected to serve in a leadership role on the consolidated case. Hagens Berman has a proven track record of being appointed to leadership roles in complex, multidistrict litigation regarding investor fraud and other consumer rights issues, and your claim will be handled by attorneys who have helped secure approximately $325 billion in class-action settlements on behalf of individuals who have suffered due to corporate malfeasance and the wrongdoing of other powerful institutions.

AM I ELIGIBLE?

What is the threshold amount to be eligible? What are “substantial” losses?

The threshold amount and the definition of "substantial" losses may vary depending on a number of factors specific to the case, including the size of the company, market cap, shares outstanding and who holds them and the damages alleged by the fraud. In general, to be eligible to participate in a class-action lawsuit, you must be able to demonstrate that you suffered financial losses as a result of the alleged wrongdoing and that your losses meet the criteria set by the court or law firm. Fill out the form and submit your losses.

CAN I PARTICIPATE?

Am I affected? What do I need to do to participate?

If you were an investor in UNH, you may be affected and eligible to participate in the case. To determine your eligibility and potential involvement, fill out the form and submit your losses.

Can any UNH investor participate?

In most class-action investigations and cases, any investor who meets the eligibility criteria, including purchasing the shares during the relevant period, can participate, regardless of the size of their investment. Fill out the form to find out your rights.

I bought on a non-U.S. Exchange. Can I participate?

No. This investigation only covers shares bought on a U.S. exchange, i.e. NASDAQ or NYSE. Fill out the form to find out your rights.

Am I included if I still hold my shares, or do I need to sell to participate?

Participation is based on purchasing shares during the relevant period, rather than your current holdings. Accordingly, you do not need to sell to participate. Fill out the form to find out your rights.