The US Department of Justice (DOJ) is investigating UnitedHealth Group for possible Medicare fraud, the Wall Street Journal reported on Wednesday. According to the report, the Justice Department’s healthcare fraud unit is leading the probe, which has reportedly been active since at least mid-2023.

Officials familiar with the case told the Journal that the probe is focused on UnitedHealth’s Medicare Advantage business. It is a program in which private insurers, like UnitedHealth, receive payment from the government to offer Medicare benefits to the elderly and disabled.

Neither the Justice Department nor UnitedHealth has issued any statement on the investigation. The investigation comes on top of several other probes into the company, including whether it has been its billing practices and possible antitrust violations.

STOCK TROUBLES, EXECUTIVE SHAKE-UPS

The probe hits UnitedHealth at a challenging time. The stock price has fallen hard, plummeting almost 50% over the last month. The decline occurred after the replacement of its CEO. Andrew Witty resigned this week and was succeeded by Stephen Hemsley, the former CEO and now chairperson of the company.

UnitedHealth has also had a tough year. In 2023, a cyberattack on one of its technology units led to months of delayed payments to US healthcare providers. The company also had to contend with the murder of a high-ranking executive in its insurance business.

DOJ OLD CASE STILL UNRESOLVED

The Justice Department’s criminal fraud section specialises in cracking down on health-related offences like false billing and kickbacks.

But it has struggled in previous attempts to substantiate fraud charges against UnitedHealth. In March, a court-appointed special master recommended dismissing a longstanding whistleblower complaint. The complaint was related to $2 billion worth of disputed diagnoses that, by internal reviews, were not documented in patients’ medical charts.

Although the judge did not issue a decision, the Justice Department argued against the recommendation. UnitedHealth said the finding showed “there was no evidence to support the DOJ’s claims we were overpaid or that we did anything wrong.