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US launches antitrust investigation into UnitedHealth, WSJ reports

Market Spectator February 27, 2024
The corporate logo of the UnitedHealth Group appears on the

The corporate logo of the UnitedHealth Group appears on the side of one of their office buildings in Santa Ana, California

(Reuters) -The U.S. Department of Justice has launched an antitrust investigation into UnitedHealth Group, the Wall Street Journal reported on Tuesday, citing people with knowledge of the matter.

Investigators have in recent weeks been interviewing healthcare industry representatives in sectors where UnitedHealth competes, including doctor groups, the report said.

During their interviews, investigators have asked about issues including certain relationships between the company’s UnitedHealthcare insurance unit and its Optum health services arm, which owns physician groups, among other assets.

UnitedHealth’s unit, Optum Health, offers a range of healthcare solutions, from pharmacy benefit management to financial consultation and mental health support.

Americans are facing soaring healthcare costs, with the estimated healthcare spending per person standing at about $13,493 in 2022, according to federal data released late last year.

The Biden administration has made lowering drug prices a priority. It passed the first U.S. drug pricing legislation ever in the Inflation Reduction Act last year, and has since turned its sights on pharmacy benefit manager middlemen.

Lawmakers and the Federal Trade Commission (FTC) have been investigating the role of these middlemen in rising healthcare costs. Several bills have been in the works since last year that would require them to make their business dealings public, including the fees they earn on transactions.

The WSJ also reported that the DOJ is examining the company’s Medicare billing practices to see if doctors are aggressively characterizing their patients illnesses to wrongly increase payments from the government.

Investigators have asked about possible impacts of the company’s doctor-group acquisitions on rivals and consumers, the WSJ report said, citing the people.

The company also competes with CVS Health and Cigna that offer health insurance plans along with pharmacy benefit management (PBM) businesses.

The DoJ has previously sued to stop UnitedHealth Group’s acquisition of Change Healthcare in February 2022, but completed the buyout later that year.

An outage due to a cybersecurity attack at billing and data systems provider Change Healthcare has caused disruptions across healthcare businesses in the United States since last week.

The DoJ and UnitedHealth declined to comment.

Shares of the company closed 2.3% lower.

Examiner Media reported on Monday, citing an internal email, that UnitedHealth received a notice from the DoJ last October, saying it had begun a “non-public antitrust investigation into the company”.

(Reporting by Sriparna Roy in Bengaluru and Patrick Wingrove in New York; Editing by Shailesh Kuber, Maju Samuel and Sherry Jacob-Phillips)

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