UnitedHealth Group 10.2 Confirmed: DOJ Criminal Probe Expands to Optum Rx and Physician Reimbursement — Senate Finds 'Aggressive' Medicare Advantage Gaming
Not just Medicare: UnitedHealth's Optum also gets its own DOJ checkup
Sources (2)
Not just Medicare: UnitedHealth's Optum also gets its own DOJ checkup
UnitedHealth 'aggressively' gaming Medicare Advantage risk scores
UnitedHealth Group's DOJ criminal investigation — previously focused on Medicare Advantage billing practices — now spans Optum Rx and physician reimbursement simultaneously, per reporting confirmed by multiple outlets. A separate Senate Judiciary Committee investigation led by Sen.
Grassley found that UHG 'aggressively' games Medicare Advantage risk scores through home health risk assessments, coder review programs, and incentivized external diagnosis capture. UHG states it is cooperating and has not been accused of wrongdoing.