The Justice Department has initiated an antitrust investigation into UnitedHealth Group, according to a report by the Wall Street Journal on Tuesday. This investigation comes as Americans continue to face rising healthcare costs, with estimated spending per person reaching about $13,493 in 2022.
In recent weeks, investigators have been conducting interviews with representatives from various sectors within the healthcare industry where UnitedHealth competes. This includes doctor groups, where they have been asking about certain relationships between the company’s UnitedHealthcare insurance unit and its Optum health-services-arm, which owns physician groups and other assets.
Optum Health, a unit of UnitedHealth, provides a wide range of healthcare solutions, including pharmacy benefit management, financial consultation, and mental health support. The Biden administration has made it a priority to lower drug prices, passing the first-ever US drug pricing legislation in the Inflation Reduction Act last year. They have also been focusing on pharmacy benefit manager middlemen to address rising healthcare costs.
The role of these middlemen in contributing to rising healthcare costs has been under investigation by lawmakers and the Federal Trade Commission. There are several bills in the works that would require these middlemen to make their business dealings public, including the fees they earn on transactions.
The DOJ is also examining UnitedHealth’s Medicare billing practices to determine if doctors are exaggerating their patients’ illnesses to wrongfully increase payments from the government. Investigators have been inquiring about the potential impact of the company’s doctor-group acquisitions on rivals and consumers. UnitedHealth competes with other companies such as CVS Health and Cigna, which offer health insurance plans along with pharmacy benefit management businesses.
The DOJ had previously tried to stop UnitedHealth’s acquisition of Change Healthcare in February 2022, but the buyout was completed later that year. Change Healthcare recently experienced an outage due to a cybersecurity attack, causing disruptions across healthcare businesses in the United States.
The DOJ declined to comment on the matter, and UnitedHealth did not immediately respond to a Reuters request for comment. Shares of the company closed down 2.3% following the news. Examiner Media reported on Monday that UnitedHealth had received a notice from the DOJ in October last year, informing them of the initiation of a “non-public antitrust investigation into the company.”
